Ultrasound-guided percutaneous cholecystostomy was performed in 11 patients. Indications were acute cholecystitis in 7 patients, and obstructive biliary disease in 4 patients. A transhepatic approach was used in all patients. In one patient, bile leakage was noticed during cholecystectomy. No other complications were seen. Three of five patients with a acalculous cholecystitis had a normal post-drainage cholangiogram and the drainage catheter could be removed. A follow-up of 5.5, and 26 months respectively, showed no recurrent disease. Three patients underwent surgery and the remaining five patients were drained until death by their underlying disease. Percutaneous cholecystostomy can be a life-saving and curative procedure in the critically ill patient, and, in case of acalculous cholecystitis, the only one needed.