Laparoscopic cholecystectomy is now the treatment of choice for the surgical treatment of uncomplicated cholelithiasis. Application of this rule in acute cholecystitis is still controversal, in spite of the eagerness of the experts in the field of laparoscopic surgery.The role of a laparoscopic cholecystectomy in patients with acute cholecystitis was evaluated by comparing clinical data from a laparoscopic cholecystectomy group with those from an open cholecystectomy group.Clinical data for 24 patients with acute cholecystitis who underwent a laparoscopic cholecystectomy in the mid 1990, were compared with data for 31 patients with acute cholecystitis who went through an open cholecystectomy in the early 1990s. Preoperative clinical data showed no statistical difference between the laparoscopic cholecystectomy group and the open cholecystectomy group. The operating time, the postoperative hospitalization, the duration of drainage, and the returning time of intestinal motility were shorter in laparoscopic cholecystectomy group, and the incidence of wound infection was lower. However, the incidence of bile duct or bowel injury was larger in the laparoscopic cholecystectomy group. Laparoscopic cholecystectomy can be performed safely in most patients with acute cholecystitis, in spite of the difficulties in observation, traction and dissection, which can be overcome with complete understanding, confirmation of the biliary anatomy, and sufficient experience.