Abstract The incidence of Gall Bladder cancer (GBC)is on a rise in India, particularly in the northern parts of the country.The incidence of GBC among women in northern India is one of the highest in the world.The etiopathogenesis of GBC is not well understood. However, the wide geographical and ethnic variations in the incidence of GBC suggest a role of genetic and environmental influences on its carcinogenesis. While gall stones are considered as an important risk factor for GBC only 1 to 3 percent of patients with symptomatic cholelithiasis develop GBC. Other proposed risk factors include female sex, Salmonella typhi carrier status, dietary factors, heavy metals in drinking water and other environmental exposure to specific chemicals. However, the current knowledge about the risk factors for GBC is limited.