Background: Acute cholecystitis (AC) is defined as acute inflammation involving the gallbladder wall. This study was analytical prospective study, included 50 patients, who presented with acute calculus cholecystitis. All the patients were treated by early laparoscopic cholecystectomy (LC). Methods: The diagnosis AC was made clinically followed by ultrasonography in all patients according to revised Tokyo guidelines diagnostic and severity assessment criteria 2013. According to the severity, the patients were divided in into mild (n=26)) and moderate groups (n=24)), while according to timing of surgery, the patients were divided into group 1: ≤ 3 days from the onset of symptoms (n=26), group 2: > 3 days to ≤ 7 days (n=16) and group 3: > 7 days (n=8). Results: the mean of intraoperative blood loss was significantly larger in the moderate group. A delay in the timing of surgery was associated with higher incidence of intraoperative difficulties. Moderate group and delayed surgery was associated with higher incidence of postoperative complications and a significant longer operative time and being associated with larger amounts of intraoperative blood loss. Conclusion: LC for both grade I and grade II AC according Tokyo guidelines 2013 severity assessment is safe and feasible procedure and should be performed as early as possible, as early LC is associated with the least complications and least intraoperative difficulty particularly when performed within seven days from the onset of symptoms.