Background: Acute cholecystitis is a common surgical problem and was usually treated with conservative management followed by surgery after an interval of 6/8 weeks. The aim of the study was to compare the efficacy of immediate with delayed laparoscopic cholecystectomy. Methods: Randomized controlled trial in RRMCH from January 2019 to June 2019 was conducted on patients diagnosed to have acute cholecystitis. The 25 patients underwent immediate laparoscopic cholecystectomy within 24-72 hours of admission and 25 patients underwent DLC. Results: In the early surgery group intraoperative complications noted were adhesions, bleeding, GB perforation and bile duct injury. Although the percentage of complications was high in delayed group no statistical significance could be derived between the groups Conclusions: Early laparoscopic cholecystectomy (ELC) surgery had similar intra and postoperative complications compared to delayed surgery in acute cholecystitis but was associated with a shorter surgery and lesser stay in hospital.