In recent years, percutaneous cholecystostomy (PC) has emerged as a pivotal minimally invasive intervention for patients with complicated and high-risk acute cholecystitis (AC), and its clinical application has been increasingly widespread. However, in China, controversies persist regarding the indications, perioperative management, and subsequent treatment strategies of PC. These inconsistencies not only compromise the uniformity of clinical practice but also impede the standardized promotion and rational utilization of this technique. Drawing on relevant domestic and international guidelines, the latest research advances, and considering China’s specific national context, “Chinese expert consensus on percutaneous cholecystostomy for treatment of acute cholecystitis (2025 edition)” addresses 10 key clinical issues and puts forward 24 recommendations covering critical aspects including surgical indications, timing of intervention, imaging guidance, selection of puncture routes, prevention and management of complications, and post-procedural treatment strategies. The consensus is intended to facilitate the standardized application of PC in clinical practice.