Objective To explore the clinical characteristics and surgical indications of polypoid lesions of the gallbladder (PLG) . Methods The clinical data of 331 patients with PLG who underwent surgery in Department of General Surgery from August 2008 to December2013 were analyzed retrospectively. Comparison of ratios between two groups was analyzed by chi- square test. Results Among the 331 surgical cases, there were 13 cases with adenomatous polyps (3. 9%) and 318 cases with non- adenomatous polyps (96. 1%) . After comparing the clinical characteristics of the two groups, significant differences were observed in the following parameters: sex (χ2= 6. 2, P =0. 013) , age (≥40 / < 40) (χ2= 3. 90, P = 0. 048) , sizes of polyps (≥10 mm / < 10 mm) (χ2= 77. 4, P < 0. 000 1) , number of lesions (multiple /solitary) (χ2= 6. 2, P = 0. 013) , PLG basal width (≥6 mm / < 6 mm) ( χ2= 111. 8, P < 0. 000 1) , and presence or absence of concomitant calculi (χ2= 7. 5, P = 0. 006) . Conclusion Clinical symptom is considered an indication for surgery. For most of the gallbladder polyps, the risk of malignant transformation is extremely low. Other surgical indications for gallbladder excision include age≥40 years, single polyps measured ≥10 mm in diameter, polyp basal width ≥6 mm, recent rapid polyp growth, and tumor- associated factors such as polyps with calculi.