Background: Congenital gallbladder agenesis is a rare anomaly of the biliary tree. This asymptomatic situation is sometimes complicated with symptoms mimicking "gallbladder disease". This case presentation shows the importance of a thorough preoperative investigation in order to avoid the increased risk of iatrogenic injury to the biliary tree. Case report: A 45-year old woman consulted her surgeon complaining of right upper quadrant pain, which was precipitated by fatty meals. After routine ultrasound investigation, she was scheduled for laparoscopic cholecystectomy. During the operation, there was no evidence of a gallbladder, even after thorough dissection of the porta hepatis. The procedure was terminated and postoperative MRCP confirmed the diagnosis of gallbladder absence. Conclusion: Gallbladder absence is a very rare congenital abnormality of the biliary tree. During laparoscopy, thorough dissection of Callot's triangle increases the risk of iatrogenic injury. Preoperative advanced imaging studies are needed when routine investigation is equivocal.