Acute acalculous cholecystitis is characterized by inflammation of the gallbladder without the presence of gallstones. It is commonly seen in older and critically ill patients. The etiology of this condition is broad and includes infective, inflammatory, traumatic, and connective tissue disorders. Acute acalculous cholecystitis is associated with a higher risk of complications like gangrene and perforation. Clinical examination and laboratory investigations are not sensitive for the diagnosis of acute acalculous cholecystitis. Ultrasonography is the first-line imaging modality to diagnose acute acalculous cholecystitis, followed by Cholescintigraphy. The management of acute acalculous cholecystitis can be divided into cholecystectomy and percutaneous cholecystostomy. In this review, we will investigate the risk factors, investigations, and treatment of acute acalculous cholecystitis.