Needlescopic surgery is a refinement of laparoscopic surgery wherein instruments smaller than 3 mm are used. The advantage is the minute wounds that heal imperceptibly. Initial reports of needlescopic cholecystectomy were confined to uninflamed gallbladders where the antegrade technique was invariably used. This case demonstrates a needlescopic cholecystectomy by the retrograde approach for an inflamed gallbladder.