Endoscopic gallbladder drainage is performed for high-risk patients with acute calculus cholecystitis who are not fit to undergo a cholecystectomy. Endoscopic transpapillary gallbladder drainage and endoscopic ultrasound-guided gallbladder drainage are the two procedures performed. Both procedures require specialized training and equipment, and the most common complications include perforation, bleeding, and stent migration. In this review, we will investigate the role that endoscopic transpapillary gallbladder drainage and endoscopic ultrasound gallbladder drainage play in the management of acute calculus cholecystitis in high-risk patients who would not undergo a cholecystectomy. We will also review the indications and complications of these procedures and compare them with percutaneous cholecystostomy in the management of acute calculus cholecystitis.