Introduction: Laparoscopic cholecystectomy has become a popular alternative to open cholecystectomy in the treatment of acute cholecystitis. Cholecystitis is inflammation of gall bladder. More than 90% of acute cholecystitis is from blockage of cystic duct. Cholecystectomy is the surgical removal of the gall bladder. It is the common treatment of symptomatic gallstones and other gallbladder conditions. Laparoscopic cholecystectomy is now considered the gold standard therapy for symptomatic cholelithiasis and chronic cholecystitis. While laparoscopic cholecystectomy has become the approach of choice for elective cholecystectomy, but some cases of acute calculus cholecystitis are nowadays still operated with the open techniques. Materials and Methods: It is a comparative study of 100 patients of acute calculus cholecystitis aged 53± 10 years operated during 2007–2008 in Department of General surgery, Rajendra institute of Medical sciences ,Ranchi. They were divided into two groups, first group consists of 70 patients who underwent laparoscopic cholecystectomy and second group includes 30 patients who underwent open cholecystectomy for acute cholecystitis. Patient’s written valid informed consent for the particular procedure was taken and the pros and cons of both the procedure were explained in detail to the patients. Results: 70 patients underwent laparoscopic surgery and 30 patients had open surgery. The demographic data and co–morbidities were comparable between the two groups. Conversion from laparoscopic to open surgery was necessary in 20% of the patients.The mean operative time was 70 minutes for the open cholecystectomy group and 80 minutes for the laparoscopic group.The postoperative hospital stay was significantly shorter for patients undergoing laparoscopy. The overall morbidity rate was significantly lower for patients undergoing laparoscopy. There was no statistical significant difference in the mortality rate. There was no major bile duct injury for patients in either group. Conclusion: In acute calculus cholecystitis, post–operative morbidity, mortility, hospital stay,operative times and severe intraoperative hemorrage were reduced by laparoscopic cholecystectomy but promptly terminated by conversion to open cholecystectomy if operative conditions make anatomical identification difficult. The indication for cholecystectomy,either laparoscopic or open, should be based on patient–related factors.