Objective To investigate the clinical application of three-dimensional magnetic resonance(MR)visualization in difficult laparoscopic cholecystectomy.Methods A total of 100 patients with gallstones who were admitted to the Second People's Hospital of Shantou from January 2022 to December 2023 were selected as research objects.The patients met the criteria of"difficult gallbladder"and were assigned to two groups according to random number table.The control group(n=50)were treated with routine laparoscopic cholecystectomy.In the observation group(n=50),laparoscopic cholecystectomy was assisted by MR 3D visualization model.Surgical indexes,pain within 1 day after surgery,risk of intraoperative trauma,and incidence of postoperative complications were compared between the two groups.Results Surgical indexes and recovery indexes in the observation group were superior to those in the control group(P<0.05).The visual analogue scale(VAS)score within 1 d after operation was significantly lower than that before operation in both groups,and the improvement of VAS score in the observation group was better than that in the control group(P<0.05).The incidence of gallbladder rupture(0.00%vs 10.00%)and liver margin injury(0.00%vs 8.00%)in the observation group were lower than those in the control group(P<0.05).The incidence of complications in the observation group was significantly lower than that in the control group(2.00%vs 14.00%,P<0.05).Conclusion The construction of MR 3D visualization model can provide clearer surgical field for laparoscopic cholecystectomy,and enable the operator to clarify the anatomical structure of the gallbladder,avoid surgical trauma,improve the postoperative recovery,alleviate postoperative pain,and reduce the risk of complications.