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Gallbladder cancer (GBC) represents the most common malignancy among the biliary tree cancers representing 3% of such tumors. Complete surgical resection offers the best chance for cure. Adjuvant chemotherapy and radiotherapy are less well-defined and need to be further evaluated to increase local and systemic control. Local recurrences as high as 75% have been reported after radical cholecystectomy in GBC. The patterns of failure and poor overall prognosis in GBC, justify administration of adjuvant treatments. Only an estimated 20% of patients receive radiotherapy or chemotherapy after resection and fewer than 10% of all presenting patients undergo surgery, radiotherapy and chemotherapy. Recent series have suggested that local-regional control and possibly ultimate outcome can be improved by the use of adjuvant therapy.