Objective To explore the operative main points and clinical effects of LC treatment for acute calculous cholecystitis. Methods Between August 2006 and June 2008, LC treatment for acute calculous cholecystitis in 120 cases as performed, the data of which were analyzed retrospectively. Of these patients, there were gallbladder with adherent omentum (72 cases), gallbladder with adherent hepatic flexture of the colon (9 cases), gallbladder with duodenum (5 cases), obstruction of the cystic duet by a gllstone (68 cases), and Mirizzi syndrome(2 cases). Results All the 120 cases performed LC successfully. There were no converting to open operation, and no biliary leakage. The mean operating time was (45. 0 ± 13. 1) minutes. Conclusions Acute calculous cholecystitis was not a contraindication for LC. Rich experience and skilled technique were key points for the success of operation. It shows advantages of less pain, less complications and more rapid recovery.