Background and aim: Laparoscopic cholecystectomy is the preferred treatment for gallstones. The aim of this study is to evaluate the role of Laparoscopic cholecystectomy in patients with acute cholecystitis and comparison with open cholecystectomy and elective laparoscopic cholecystectomy in regard with side effects, the rate of converting to the open procedure, duration of hospitalization and duration of surgery. Materials and Methods: A retrospective cross-sectional study was done on 235 patients, including 94 patients with a diagnosis of acute cholecystitis in an emergency by using one of two methods: open surgery (48 cases) or laparoscopic cholecystectomy for acute cases (46 cases). The third group including 141 patients with symptomatic stones was undergoing elective laparoscopic cholecystectomy. All patients had a confirmed diagnosis through ultrasound. Results &Findings: The mean length of hospitalization was 5.3 and 2 days in open surgery, acute laparoscopy and elective laparoscopy, respectively. The mean time of surgery was 58/8 ± 29/3, 53/2 ± 3/2 and 18.8 ± 39.9 minutes, in open surgery, acute laparoscopy and elective laparoscopy, respectively. Main complications in patients with open surgery -5 cases- was (10.4%), in patients with acute laparoscopy, 2 cases (5.1%) and in patients with elective laparoscopy -5 cases, was (3.6%). Conclusion: This study showed that laparoscopic acute cholecystectomy compared with open cholecystectomy is along with by reducing the length of hospital stay, postoperative hospital stay and main complications and should be considered as the first choice before make decision for doing open cholecystectomy.