Acute calculous cholecystitis is a common surgical problem. Although laparoscopic cholecystectomy is the standard therapy for these patients, some may not be suitable candidates for surgery owing to serious comorbidities, high surgical risk, or severity of the cholecystitis and its local and systemic consequences. In selected cases, percutaneous cholecystostomy may be an alternative to surgery; however, there are no definite recommendations for patient management after this technique is performed. Surgery may be not an appropriate treatment for such patients for the rest of their lives. This review discusses the main indications of percutaneous cholecystostomy and its management based on the findings of recently published literature.