Acute cholecystitis is an acute inflammation of the gallbladder and one of the most common complications of symptomatic gallstones. Risk factors for gallstones are age, gender, obesity, and genetics. Acute obstruction of the gallbladder with stones leads to seizures - constant pain that occurs in the epigastrium and right upper quadrant of the abdomen, can pierce to the back, to interscapular region or in the right shoulder. Diagnosis is the first step in the treatment of acute cholecystitis, and specific diagnostic criteria are needed for the precise diagnosis in typical, as in atypical cases. Signs that confirm a diagnosis of acute cholecystitis ultrasonic Murphy's sign, thickened gallbladder wall and an enlarged gallbladder. In the time of open cholecystectomy, the advantage was given to the early cholecystectomy before late elective surgery. Recent randomized studies obtained similar results for early laparoscopic cholecystectomy. Essentials for performing a laparoscopic cholecystectomy for very acute situations are: to operate less than 72 hours from the onset of the acute attack, an experienced surgeon with more than 200 cholecystectomies, nurses well trained in advanced laparoscopic procedures, and good instrumentation. .Studies indicate that early laparoscopic surgery in the treatment of acute cholecystitis is safe. Delay in operation until resolution of simptoms during the same hospitalization showed no adventage with regard to operative time or complication rate. Furthermore, early laparoscopic intervention significantly reduced operative blood loss, showed a trend toward reducing conversion rates, and significantly reduced total hospital days and total hospital charges. These findings support the use of early laparoscopic cholecystectomy during the first admission in the treatmant of acute cholecystitis.Despite a longer postoperative hospital stay, the total hospital stay and the recuperation period are significantly reduced. Early laparoscopic cholecystectomy combines the merits of early surgery with those of minimally invasive surgery and can provide maximal economic gain.