Gall bladder perforation (GBP) is an uncommon complication and is usually associated with a high mortality due to delayed diagnosis and mostly requires urgent surgical intervention with the most common cause being acute cholecystitis.[1] Malignancy has also been attributed as a causative factor in some cases [2] with a single reported case of GBP secondary to chemotherapy and radiotherapy [3] This case report pertains to an interesting and complicated case of Type II GBP (Based on classification by Neimeier[4]) secondary to adenocarcinoma of the gall bladder with formation of a perihepatic collection with multiple calculi in the perihepatic space.