Gallbladder cancer (GBC) remains one of the most lethal gastrointestinal malignancies, characterized by aggressive biology and poor survival. Despite advances in molecular profiling and systemic therapies, innovations have not translated into proportional survival gains in many regions, suggesting underrecognized determinants of prognosis. In this opinion review, we argue that healthcare system logistics represent a critical, modifiable factor influencing GBC outcomes. In intermediate-incidence