Gallbladder internal fistula is a rare complication of the biliary system. A lack of specific clinical manifestations of gallbladder internal fistula results in a low preoperative diagnostic rate. Surgery remains the main treatment method for gallbladder internal fistula; however, it may cause injuries in adjacent organs and postoperative complications such as biliary fistula and intestinal fistula. Laparoscopic surgery has the advantages of little trauma, fast recovery, and mild pain and has become a new trend in the treatment of gallbladder internal fistula. This article reviews the pathogenesis, clinical manifestations, and diagnosis of gallbladder internal fistula, as well as the selection of treatment modalities.