An uncommon case of undifferentiated carcinoma of the gall bladder in a 65 year old Chinese man, who presented with an increased serum alpha-fetoprotein concentration, is reported. Histologically, the tumour had a primitive appearance and was composed of a pavement-like array of poorly differentiated columnar/polygonal cells. Alpha-fetoprotein was demonstrated in some of the tumour cells using an immunoperoxidase technique. Alpha-fetoprotein secretion in this instance may have occurred because the gall bladder and the liver are of similar embryological origin. Alpha-fetoprotein may also be related to the resurgent expression of oncofetal antigens. This tumour may represent another rare cause of increased serum alpha-fetoprotein concentrations.