Neuroendocrine tumors of the gall bladder are notoriously rare accounting for a mere 0.2% of all neuroendocrine tumors (NET).  Our appreciation of the clinical behaviour of these tumours is hence limited.  The rarity of this pathology lies in the absence of entrochromaffin and other neuroendocrine type cells in the gall bladder mucosa.  Histopathologically, these tumours may reveal carcinoids (well-differentiated endocrine carcinomas), small-cell carcinomas (poorly-differentiated endocrine carcinomas) and mixed endocrine-exocrine carcinomas.  Herein, we report the history, diagnosis and subsequent management of a patient residing in Warwickshire, United Kingdom who was found to have a poorly-differentiated NET of the gall bladder.  We discuss the implications of immunohistochemical activity and conclude with a review of the literature concerning the aetiology, clincal presentation, prognosis and management of this rare tumor.