Spontaneous internal billiary fistulas between the gallbladder or bile ducts and intestinal tract occur as a result of gallstone, peptic ulcer, carcinoma and uncommon diseases. Their incidence appears to increase recently with the advent of endoscopy. The main types of fistulas are cholecystoduodenal, cholecystocolonic, choledochoduodenal. Cholecystogastric or choledochogasric fistula is very rare type of spontaneous internal biliary fistulas. Pneumobillia has been considered as a clue, but their symptoms are usually nonspecific so the diagnosis is difficult in most cases. Complications of spontaneous internal biliary fistulas include gallstone ileus, ascending cholangitis, severe diarrhea, and gastrointestinal hemorrhage. The management of patients with spontaneous internal biliary fistulas are usually complex and often controversial. On evaluating the cause of fever and right upper abdominal pain in a 65-year-old female, we confirmed a case of choledochogastric fistula with abdominal CT scan, endoscopy and endoscopic retrograde cholangiopancreatography.