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Gallbladder cancer is one of highly malignant digestive system tumors with insidious symptoms, rapid progression, and poor prognosis. Although radical resective surgery is the only possible curative way for gallbladder cancer, most patients have lost the opportunity to undergo surgery when diagnosed. The neoadjuvant therapy had been used for many malignant tumors in digestive system including pancreatic cancer. The neoadjuvant therapy also had been used for gallbladder cancer including chemotherapy, radiation therapy, immunotherapy and molecular targeted therapy in the treatment of patients with advanced gallbladder cancer, and has achieved some effects. A few patients benefited from downstaging and got the opportunity to have R0 resection after neoadjuvant therapy. However, there are still many controversies and challenges, including the inconsistent criteria for evaluation of resectable gallbladder cancer, the absence of standardized protocols for neoadjuvant therapy, increasing rate of postoperative complications after neoadjuvant therapy compared to the patients undergoing direct surgery, and lack of criteria of both indications and evaluated effects of neoadjuvant therapy. Therefore, it should still need more high-quality prospective clinical trials to resolve these controversies and clinical applications.