Aim: Laparoscopic cholecystectomy gives rise to a very complicated issue concerning the use of antimicrobial prophylaxis. 
The role of antibiotic prophylaxis in elective laparoscopic cholecystectomy and the relation between post-operative septic complication and bile microbiology will be assessed in this study. 
Patients and methods: 64 patients were included in the study and divided into two groups; group A: (29 patients) received antibiotic prophylaxis (cefotaxime) and group B (35 patients) received 100ml isotonic saline (placebo). Bile sampling and culture was taken for all cases and the patients were followed up for incidence of sepsis where the wounds were swapped and cultured. 
Results: Bile sampling and culture revealed no growth in 41 cases (64.1%) (19 in group A and 22 in group B). Postoperative infection developed in two cases of group A and in three cases of group B. Incidence of wound infection was significantly related to incidence of GB perforation (p < 0.0001). Swabbing of infected wounds and collections revealed infecting organisms other than that detected in bile culture except in one case of group B. 
Conclusion: There is no relation between bile microbiology and postoperative infection, so, antibiotic prophylaxis is to be used in high-risk patients and in patients suspected to have difficult operation and GB perforation