Gallbladder torsion is a rare but potentially life-threatening event due to its insidious course and to the gravity of the clinical picture when the diagnosis is established late. In 85% of cases this situation affects females, aged 70 to 90 years. The aetiopathogenesis is still unknown and the diagnosis is often made during surgery. A thorough review of the literature suggests a specific clinical pattern which, when combined with improvements in radiological techniques, should allow early diagnosis and treatment. Nevertheless, only 10% of cases are correctly diagnosed before surgery. The aim of this case report was to evaluate the specific pattern of this clinical picture and the accuracy of the radiological and laboratory findings for the purposes of achieving an early diagnosis and adequate treatment.