ABSTRACT Background and Aims Gallbladder and biliary diseases remain a major contributor to the causes of global disease burden. The study aims to provide updated estimates and projections of the global burden of gallbladder and biliary diseases from 1990 to 2021. Method We extracted age‐standardised prevalence rate (ASPR), incidence rate (ASIR) and disability‐adjusted life years rate (ASDR) from the 2021 Global Burden of Disease Study (GBD). We analysed the data by calculating the annual percentage change (EAPC) and stratified the data by sex, across 20 age groups, 21 GBD regions, 204 countries and territories, and five Socio‐demographic Index (SDI) quintiles. Result The global burden remained grim, with a total number of 251 574 857 cases [95% uncertainty interval (UI): 215272108–293 541 994] and an ASPR of 2966.7 per 100 000 persons (95% UI: 2551.7–3447.6) in 2021. The ASIR was 865.4 per 100 000 persons (95% UI: 747.6–1000.8), with the ASDR of 91.7 per 100 000 persons (95% UI: 69.6–122.1). Regionally, Central Europe had both the highest ASPR and ASIR, while Central Latin America showed the highest ASDR. Globally, 35.9% of gallbladder and biliary diseases burden is attributed to high Body mass index (BMI) and 4.8% to smoking. It is projected that by 2040, the global burden of gallbladder and biliary diseases will rise slightly across these main indicators. Conclusion Although the global prevalence of gallbladder and biliary diseases has been declining over the past 32 years, the severe economic burden caused by it still exists, and there are huge differences between the levels of development of different regions and countries.