Background: While some observational studies showed that mini-laparoscopic procedures lengthen the time required to complete cholecystectomy, others showed that mini-laparoscopic cholecystectomy (MLC) has a similar operative duration to standard laparoscopic cholecystectomy (LC) with a lower rate of morbidities. To our knowledge, no prospective randomized trial compared the outcome. Objective: The aim of this work was to compare the outcome of MLC versus conventional LC. Methods: This was a prospective randomized comparative study that enrolled hundred and two patients with chronic calcular cholecystitis. Eighty-four patients were eligible and randomized into 2 groups. Detailed pre-, intra- and postoperative data were collected. All cases were evaluated according to difficult laparoscopic cholecystectomy scoring systems, Soltes scoring system, Randhawa scoring system and Visual Analogue Scale (VAS). Results: There was a statistically significant higher mean operative time among MINI group than the conventional group (47.62 versus 37.98 minutes). Mean VAS score was statistically significantly higher in the conventional than MINI group (4.76 versus 2.95). A statistically significant higher mean cosmetic satisfaction score among cases with MINI group than conventional group (4.62 versus 2.26). There was no significant difference between studied groups regarding the intraoperative, postoperative complications and conversion rate. Conclusion: Mini-laparoscopic cholecystectomy showed better results concerning postoperative pain and led to better patient satisfaction with the cosmetic result, in comparison to conventional LC. MILC took longer to be performed, but was not associated with serious complications or a high conversion rate. Mini-laparoscopic cholecystectomy is a safe and feasible procedure for gallbladder disease in elective cases.