Background: Present prospective observational study was planned to find out clinico-pathological relevance of expression of PD-L1 in carcinoma Gall Bladder. Materials & methods: After obtaining institutional ethical clearance, this observational study was conducted in the department of surgical gastroenterology, KGMU Lucknow. A total of 68 patients of gall bladder carcinoma (resectable, unresectable, metastatic, and incidental) proven by histopathology were prospectively recruited from February 2020 to December 2021. Patients, between 18 to 70 years age and those had been given informed consent were included in the study. Patient with ECOG 3 and 4 were excluded.Information of worked up 68 patients of GBC were retrieved from a prospectively collected computerized data system. Data such as age, gender, comorbidities, symptoms, clinical examinations (general physical and per abdominal), routine blood investigations (CBC, LFT, KFT, PT INR), USG abdomen, tumor markers (CEA & CA 19-9), CECT abdomen & chest, details of surgical procedures, endoscopic interventions, radiological interventions, and histopathological analysis of surgical specimen and trucut biopsy were collected.Hematoxylin and eosin-stained slides of GBC were reviewed by pathologist. Primary outcome was percentage of PD-L1 expression in Gallbladder carcinoma. Criteria for positive immunohistochemical staining was based onTumor Proportion Score (TPS).It was assessed as percentage positive PD-L1. Descriptive statistics was analyzed with SPSS version 17.0 software Results: Association of PD-L1 expression with clinico and histopathological variables was seen. At a cut off 10% PD-L1 expression was found significantly associated with absence of ascites (p=0.005), presence of diabetes mellitus (p=0.000) and adjacent organ involvement (p= 0.000). Adenocarcinoma histological type (p=.005) and high TIL density (p=.000) also found significantly associated. At a cut off 1% significant association were found between PD-L1 expression and pathological (III & IVB) and TNM (T2 & T3) staging. Conclusion: The results from present study are providing rationale to further explore more evidence so that it may help in better understanding of GBC pathogenesis, in developing better techniques like uniform scoring system/ criteria to identify these molecular abnormalities and in advancement in management paradigm for better survival of gallbladder cancer patients.