Abstract
The congenital gallbladder agenesis presents a diagnostic challenge due to its atypical clinical features, often leading to misdiagnosis or delayed diagnosis and ultimately unnecessary surgeries. The role of MRI in this condition cannot be overstated. We report a case where MRI preoperatively diagnosed congenital gallbladder agenesis. Initially, routine physical examination ultrasonography misdiagnosed the patient with a gallbladder full of stones and atrophic cholecystitis, leading the patient to seek surgical treatment and get admitted to the hospital. After admission, further abdominal MRI finally diagnosed congenital gallbladder agenesis, successfully avoiding unnecessary surgery. This case underscores the key clinical lesson of leveraging MRI to prevent unnecessary surgeries.