We present a case of a 35-year-old Ethiopian female patient presented with right upper quadrant abdominal pain. Studies suspected gallbladder disease, for which she operated. Intraoperatively, gallbladder perforation with choledochogastric fistula was identified, with Ascaris lumbricoides (AL) worm in the common bile duct. Cholecystectomy was performed; common bile was repaired with T-tube and gastric repair. Patient was discharged 11 days after. On subsequent follow-up at the surgical referral clinic, the patient had no complaints.