Haemorrhagic cholecystitis is uncommon and is associated with a high risk of morbidity and mortality. This poster presents an 83-year-old comorbid woman who developed haemorrhagic cholecystitis with gross haemobilia ten days after commencing dual-antiplatelet therapy (DAPT) for treatment of a non-ST elevation myocardial infarction (NSTEMI). Emergent surgery was deemed too high risk and the patient was managed non-operatively. Subsequent clinical and biochemical resolution was observed. Prior to follow up an episode of cholangitis secondary to choledocholithiasis was managed with endoscopic retrograde cholangiopancreatography (ERCP). Complete resolution of the haemorrhagic gallbladder was demonstrated on imaging without any ongoing evidence of haemobilia or occult hepatopancreatobiliary lesions. The aetiology of spontaneous haemobilia may include malignancy, ductal obstruction, trauma or parasitic infection. Patients with associated gallbladder haemorrhage often present similarly to acute cholecystitis and they may fulfill criteria for such a diagnosis. Tokyo Guidelines (2018) recommend cholecystectomy as the definite management of cholecystitis, regardless of aetiology. This case however, highlights the importance of the clinical context in surgical decision making which may not always be consistent with guidelines. Anticoagulation-related haemorrhagic cholecystitis with haemobilia is not a common clinical problem, but this case shows that it can be managed successfully non-operatively in the first instance. Follow up is required to ensure an underlying cause is excluded with subacute choledocholithiasis being a possibility in this case.