Background: Gallstones as well as gallbladder cancer are very common in India. North East India also witnesses a large number of gall bladder carcinoma cases. Diagnosis of many unexpected pathologies including incidental carcinoma can only be done on histopathological examination of cholecystectomy specimens. Objectives: Our aim is to evaluate the histopathological spectrum of the cholecystectomy specimens done in our hospital and to determine the frequency of Incidental carcinoma along with other uncommon pathologies on histopathological examination of cholecystectomy specimens. Methods: This is a retrospective study done in the Department of Pathology, F.A.A.M.C.H., Barpeta, between September 2018 and September 2023. Results: Out of 2165 cholecystectomy specimens sent for histopathological examinations 10 specimens (0.46%) were diagnosed as chronic cholecystitis with flat dysplasia, 12 specimens (0.55%) as incidental gall bladder carcinoma and 9 (0.41%) preoperatively diagnosed gall bladder carcinoma specimens were confirmed on histopathological examination. The percentage of Gall bladder carcinoma in cholecystectomy specimen at our hospital is 0.97%. Conclusion: Chronic cholecystitis with flat dysplasia and incidental gall bladder carcinoma can be missed in pre and intraoperative periods despite clinical and radiological evaluation preoperatively. So, mandatory histopathological examination of all cholecystectomy speciemens is of utmost importance to avoid misdiagnosis and for early detection of incidental carcinoma.