OBJECTIVE To evaluate and compare the outcome of laparoscopic cholecystectomy (LC) in acute and chronic cholecystitis in terms of complications, conversion rates, reason of conversion and hospital stay. METHODS Between April 1999 and March 2004, we retrospectively evaluated all patients admitted for symptomatic gall bladder disease in the Department of General Surgery, Lahore General Hospital, Lahore, Pakistan. All patients who underwent LC for symptomatic cholelithiasis were included. They were classified as group A [having acute cholecystitis (AC)] and group B [with chronic cholecystitis (CC)] based on the operative findings and histological diagnosis. RESULTS Out of 725 patients who underwent LC, 173 patients were included in group A and 552 patients in group B. Conversion rate was 6% for group A and O.7% for group B (p<0.0001). Two patients (0.3%) in group B, while one patient (0.5%) in group A sustained bile duct injury (p>0.05). Two patients (1.1%) in group A and 4 patients (0.7%) in group B developed sub-hepatic bile collections (p>0.05). The mean hospital stay was 1.2 +/- 1.1 days for group A and 1.7 +/- 2.1 days for group B (p<0.001). CONCLUSIONS Laparoscopic cholecystectomy is a safe and effective procedure in almost all patients presenting with symptomatic cholelithiasis.