Background:Laparoscopic cholecystectomy (LC) has become the gold standard in the treatment of symptomatic gallstones, while acute cholecystitis (AC)is a common surgical condition that may require hospital admission and subsequent surgical management. The aim of this work was to compare early versus delayed LC for acute calcular cholecystitis (ACC) regarding intraoperative findings, difficulties, possible complications and the postoperative outcomes. Methods:This prospective randomized study was carried out on 70 patients aged > 18 years old, both sexes, diagnosed as ACC. Patients were divided into two equal groups: Group A: underwent early LC within 1 week from onset of symptoms and Group B: underwent delayed LC 6-8 weeks after the last attack of AC. Results: Adhesions and increased GB wall thickness were significantly higher in group A than group B (P<0.05). Drain and adhesions were significantly higher in group A than group B (P<0.05). Analgesic requirement and hospital stay were significantly lower in group A than group B (P <0.05). Drain removal was significantly different between both groups (P <0.001). Intestinal injury and Jaundice didn’t occur in any patients in both groups.Operative time, difficulty, bleeding, bile duct injury, conversion to open, bleeding and bile leakage were insignificantly different between both groups. Conclusions:Early LC seems to offer a preferable approach for patients with ACC providing a more efficient treatment with less postoperative pain and shorter hospitalization, indicating a faster recovery.