Background: Laparoscopic cholecystectomy (LC) has become the preferred treatment for symptomatic gallstone disease, but advanced age and comorbidities increase the risk of complications. The incidence of bile duct injuries during LC has also increased, with various technical factors contributing to higher rates. Aim: This study aimed to evaluate the prevalence and predictive factors of common bile duct (CBD) injury in laparoscopic cholecystectomy.  Patients and Methods: 850 patients with high-risk chronic diseases and specific gallbladder conditions were prospectively observed. Patients with symptomatic cholecystitis, gallstones, gallbladder polypoid lesions, and cirrhotic patients were included. Exclusion criteria involved certain conditions and contraindications. LC was performed using standard techniques, and peri-operative management followed local protocols. Results: The study included predominantly female participants with hypertension, diabetes mellitus and liver cirrhosis. CBD injury occurred in 5 % of cases, and it was significantly associated with cholecystitis, gallstones, gallbladder polypoid lesions, poor identification of the hepatic pedicle, technical mistakes, and difficult cases. No significant correlations were found between CBD injury and comorbidities or specific causes. Conclusion: CBD injury was linked to cholecystitis, gallstones, gallbladder polypoid lesions, poor hepatic pedicle identification, gallbladder inflammation, cumulative technical errors, and difficult cases. Surgeons should be vigilant during hepatic pedicle identification and dissection to avoid CBD damage. Cholecystitis, gallstones, and associated conditions need suitable treatment to ease symptoms.