OBJECTIVE To compare the safety and effectiveness of laparoscopic cholecystectomy (LC) versus open cholecystectomy (OC) for cirrhotic patients. METHODS The Cochrane Library, MEDLINE, Science Citation Index Expanded, EMBASE and CBM (Chinese Biomedical Database) were searched until August 2011 to indentify relevant and eligible studies. RESULTS Twenty three articles with 1316 cirrhotic patients were included. All patients were allocated to the LC group (n=694) or the OC group (n=622). They were primarily in Child-Pugh class A (n=957, 72.7%) and class B (n=343, 26.1%). Meta-analysis of 5 randomized controlled trials (n=284) indicated LC group was associated with the following advantages: significant lower surgery-related morbidity, less postoperative complications (e.g. incision hernia, wound infection), shorter hospital stay and less loss of blood. There were no significant differences in the intra-hospital mortality and total operative time between the two groups. Meta-analysis of 19 non-randomized studies (n=1082) showed similar results in favour of LC group. In addition, it showed significant lower intra-hospital mortality and less total operative time in the LC group than the OC group. CONCLUSIONS LC is safe and offers various significant benefits over OC. Thus, it should be recommended for compensated cirrhotic patients.