B ultrasound-guided percutaneous transhepatic gallbladder drainage (PTGBD) has gradually become the first choice for treatment of acute edematous cholecystitis. The PTGBD technique has been developed with the continued improvement of the surgical instruments and surgeons’ proficiency. At present, the reported literature concerning PTGBD is mostly limited to acute cholecystitis in elderly patients, but no systematic reports are available on its specific advantages, indications and timing for subsequent cholecystectomy. In this article, the authors address the above three aspects to provide indications for clinical practice.