Biliary dyskinesia due to a multiseptate gallbladder has been rarely described in literature. Septations within the lumen of the gallbladder can lead to bile resistance, causing symptoms of abdominal pain, nausea, and vomiting. The majority of cases are due to congenital malformation during the development of the gallbladder. Ultrasound (US) is usually sufficient to make the diagnosis, although other imaging techniques can be used for confirmation. We present the case of a 60-year-old female who presented to the emergency room (ER) with biliary pain due to septations in the lumen of her gallbladder.

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