Sinistroposition, or left-sided placement of the gallbladder, is a rare congenital anomaly with a prevalence of about 0.3%. These gallbladders, through multiple proposed developmental aberrations, are situated beneath segment III or IV (or both, as in this case) of the liver, and can lead to diagnostic difficulty. We present a case of atypical presentation of acute cholecystitis from a left-sided gallbladder and the modified laparoscopic technique used for its safe removal.