Gallbladder polyps are not uncommon and are often found incidentally. While they are mostly benign, some polyp features and patient risk factors raise suspicion for malignant potential and progression to gallbladder cancer. Identifying these factors is essential for the decision to refer patients to a surgeon for evaluation to minimize the risk of developing cancer. In this chapter, we discuss the patient presentation and evaluation for gallbladder polyps, and expand on the criteria for surgical referral.