To study the expression of vascular endothelial growth factor VEGF and microvessel density MVD in the progression of primary gallbladder cancer and their relationships between invasion and metastasis and prognosis. VEGF and MVD in 31 cases of primary gallbladder cancer tissue and 10 cases of chronic cholecystitis tissue were examined with immunoshistochemical staining of S-P. Both the expression of VEGF and MVD in tumor-adjacent were significantly higher than those in tumor and normal tissue (P<0.01) , MVD was significanty higher in VEGF positive for tumors than in VEGF negative (P<0.01) , The expression of VEGF and MVD were closely correlated with the differentiation, invasion, metastasis and Nevin stage (P<0.01) . The patients with VEGF positive tumors and higher MVD had a poor prognosis than those with VEGF negative tumors and lower MVD in primary gallbladder cancer. Multivariate analysis by Cox's proportional hazards model showed that the expression of VEGF is an independent prognostic factor in patients with gallbladder cancer. VEGF and MVD are highly related to angiogenesis of primary gallbladder cancer and promoting its growth. VEGF and MVD may be regarded as one of biological indicator in primary gallbladder cancer.