Laparoscopic cholecystectomy surgery was first performed in 1985 and since then it has gradually replaced open (classical) cholecystectomy as an acute cholecystitis therapy. A lot of scientific papers show laparoscopy as the better surgical method. The first laparoscopic cholecystectomy in Croatia was performed in 1992. This paper analyzes the patients who were admitted via the Emergency Department of the University Hospital Center Zagreb and underwent cholecystectomy in a two-year period (2016/2017). The relationship between open and laparoscopic methods, their number, complication frequency (intraoperative and postoperative), hospitalization time, and conversion frequency were compared. Comorbidities of patients who underwent open cholecystectomy without conversion were also considered. A total of 284 patients underwent surgery out of which 184 were laparoscopies (64.8%), 59 open surgeries (20.8%), and in 41 (14.4%) the procedure was converted. By comparing the data on complications during and after surgery, as well as the hospitalization length, the answer to the question of indications for each method is simple, as well as the choice of method: the laparoscopic method is much safer and better for the patient, and as such should be performed whenever there are no contraindications (listed in the literature) such as: pulmonary and cardiovascular diseases, previous abdominal surgeries and severe inflammation of the abdomen, liver cirrhosis, as well as equipment shortage and staff inadequacy.