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A 76-year-old man with known situs inversus totalis presented with left-sided discomfort. Abdominal ultrasonography and CT scan confirmed the diagnosis of a gallstone, as well as,situs inversus; the liver and gallbladder on the left side and the spleen on the right. The biliary system was thought to be left-right reversal, mirror image in the view of drip infusion cholangiogram and MRI. Laparoscopic cholecy stectomywas safely performed, despite of unexpected aberrant cystic artery running inferior to cystic duct of situs inversus.Laparoscopic surgeon should be careful for view of reversed relationships and also existence of other anomalies.