Acute cholecystitis is a common surgical emergency, for which ultrasound (US) is the most common first-line diagnostic imaging test. Computed tomography (CT) is an alternative or complementary test for the assessment of acute cholecystitis. Acute cholecystitis is diagnosed based on clinical history and assessment, biochemical examination, and US findings. CT is considered only in case of unclear clinical symptoms or discrepant findings. We aimed to retrospectively compare the efficiency of CT and sonography for the diagnosis of acute cholecystitis in 103 patients who underwent laparoscopic cholecystectomy for acute cholecystitis during 2009-2018. The sensitivity and specificity of US and CT were comparatively analyzed on the basis of the intraoperative findings and histological outcomes. All patients underwent US and CT, of which 60 were diagnosed with acute cholecystitis based on histopathology. US and CT demonstrated 100% and 100% specificity, 77% and 77% negative predictive value (NPV), and 72% and 85% sensitivity for the diagnosis of acute cholecystitis, respectively. Thus, CT revealed a higher degree of sensitivity for acute cholecystitis diagnosis. However, US remain the first choice of test for diagnosis.