Background: Gallstone disease is a global health problem. The incidence is 10–20% of the whole adult population. The most common infectious disease of the Gallbladder (GB) is the acute cholecystitis (AC). Objectives: evaluate the safe technique of surgery in patients with acute cholecystitis, to highlight the better method in which patient can be prevented from complications, to analyze the clinical features and surgical outcome of LC for AC, to develop a new criterion for the therapeutic strategy used for AC, especially for late AC.  Patients & Methods: The present study shows that the operation time among the studied cases ranged from 90 to 120 min with mean 105.34 min. Out of 24 LC cases 5 patients (20.8%) were converted to open cholecystectomy. These patients had unclear anatomy during LC dissection, wherein 3 patients (12.5%) had bile duct injury and 2 patients (8.3%) had bleeding. Results: Observed that the mean total hospital stays as a result of repeated readmission and recurrent attacks biliary pain were higher for patient groups with significant distribution. Therefore, the overall patient's satisfaction regarding surgical outcome, recurrent attacks biliary pain, repeated readmission, and the length of hospital stay was in favor of patients with early surgical intervention. Our results concerning patient's preference and satisfaction came in concordance with other published results of the same interest. Conclusions: The conversion rate is related to operators' surgical experience. Regarding the postoperative outcomes, financial costs and length of hospital stay, it is more helpful than LC beyond 72 hours.