Lecture : Gall bladder cancer is an aggressive malignancy that has a high incidence in North and North-Eastern India and in Chile in South America. Surgery is the only curative option; however, a large number of them are locally advanced or metastatic at presentation. The pathological depth of invasion, involvement of the liver and draining lymph nodes, all have a bearing on long term survival after radical surgery. While a simple cholecystectomy is curative for carcinoma in situ and for pT1a lesions, a radical cholecystectomy is necessary for all lesions greater than pT1a (pT1b to pT4) irrespective of lymph node status on pre-operative cross sectional imaging. According to the authors published experience, lymph node involvement is seen in as many as 35% of pT1b tumors thus justifying the need for a radical cholecystectomy. The extent of liver resection is a matter of debate amongst HPB surgeons. There is no evidence to prove the superiority of segment 4B and 5 resection versus a 2-3 cm wedge resection of the gall bladder fossa. However, for medially placed tumors or cancer near neck of the gall bladder, a segment 4B and 5 liver resection is more appropriate. Portal lymphadenectomy can be challenging on account of the various structures in the hepatoduodenal ligament and another area of controversy is deciding the need for common bile duct resection as a routine step to facilitate portal lymphadenectomy. The evidence and authors experience does not suggest a need for routine common bile duct resection unless there is direct involvement by disease process. Neoadjuvant treatment approaches are slowly beginning to impact the treatment landscape of “borderline resectable” and locally advanced gall bladder cancer. While high level randomized evidence is not yet available, there is an increasing data to suggest that borderline resectable gall bladder cancer with high risk features are likely to benefit from neoadjuvant chemotherapy followed by radical surgery and even some locally advanced tumors may also become resectable after prior chemotherapy. Revision surgery for incidentally detected gall bladder cancer is another major area of concern in this era of laparoscopic gall bladder surgery. Distant recurrences are the most common cause of treatment failures after revision surgery that should be undertaken as soon as possible after discovery of gall bladder cancer. As in upfront surgery, lymph node involvement is the most important predictor of long term survival after revision surgery for incidentally detected gall bladder cancer. The Tata Memorial Centre data on gall bladder cancer resections is presented in this lecture. Surgical approaches in gall bladder cancer continue to evolve in the era of minimally invasive surgery and this aspect is also presented in this keynote lecture.