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The purpose of this study was to determine whether offline reported three-dimensional ultrasound (3DUS) is as accurate as standard two-dimensional ultrasound (2DUS) with regard to demonstrating gallbladder disease.The cohort comprised 80 consecutive patients referred for an abdominal ultrasound examination. The participants underwent routine 2DUS assessment of the gallbladder followed by the acquisition of two 3DUS volumes of the region of the gall bladder. The two techniques were reported independently of each other, and the diagnoses were compared for correlation.There was overall agreement of the two techniques in 89% of cases with a positive predictive value of 89%, negative predictive value of 91% and a specificity of 86%. Small polyps (sub-4 mm) were the only positive discrepancies. Cohen's kappa found that there was substantial agreement between the two techniques (p = 0.05 for a two-tailed kappa 0.67), and chi-squared test found no significant difference in diagnoses (p = 0.95).This study shows that 3DUS diagnosis correlates well with 2DUS with regard to most gallbladder problems and could be sufficient as a stand-alone technique.