Purpose <p>Gallbladder volvulus is a rare condition that is often difficult to diagnose preoperatively and can present significant intraoperative challenges due to distorted biliary anatomy and possible vascular compromise. This case study describes the use of indocyanine green fluorescence imaging to assist with anatomical visualization and tissue assessment during laparoscopic cholecystectomy.</p> Methods <p>A 65-year-old woman presented with 24&#xa0;hours of nausea and right upper quadrant pain. Computed tomography and ultrasound imaging suggested acute cholecystitis without gallstones. During the subsequent laparoscopic cholecystectomy, a necrotic gallbladder volvulus was visually identified and detorted. Indocyanine green administered preoperatively enabled intraoperative visualization of the common bile duct, identification of a necrotic cystic duct and thrombosed cystic artery, and confirmation of the critical view of safety.</p> Discussion <p>Indocyanine green can help to visualize biliary anatomy during laparoscopic cholecystectomies, especially in anatomically difficult cases. In gallbladder volvulus, the distorted anatomy makes achieving the critical view of safety challenging and increases the risk of common bile duct injury. Compared with intraoperative cholangiography, indocyanine green provides faster, real-time visualization of biliary structures and may improve intraoperative identification of biliary structures.</p> Conclusion <p>Preoperative administration of indocyanine green can improve intraoperative biliary visualization. This can enable the attainment of the critical view of safety in the context of distorted anatomy caused by the gallbladder volvulus.</p>