Gallbladder cancer is the most common of all the biliary tract cancers. The main revisions of NCCN guideline version 1 in 2018 are as follows. ① The stage T2 tumor was divided as T2a(peritoneal-sided)and T2b(hepatic-sided), and the number of metastatic lymph nodes (NMLN)was revised as the new N staging system according to the 8th edition of AJCC cancer staging system. ② The preoperative workup and assessment was more comprehensive. ③ The procedure and extent of surgery was more standard. ④ The role of neoadjuvant chemotherapy was affirmed. ⑤ Radiation therapy was added in the adjuvant management.⑥ Microstellite instability (MSI) testing was proposed for unresectable diseases in the first time and Pembrolizumab was recommended only for MSI-H tumors. The development on diagnosis and management of gallbladder cancer was introduced according to the update of the NCCN guideline in 2018.