Aim: To determine the differences in-between hematological and ultrasonography findings of acute cholecystitis (AC) among middle-aged versus elderly patients. Methodology: This retrospective study was carried out after ethical approval. Patients diagnosed as case of acute cholecystitis was included and patients without findings consistent with acute cholecystitis or with pancreatitic gall stones, co-existing hepato-biliary or intestinal malignancy or with autoimmune biliary disease were excluded. Patients were divided into two groups, one being patients between 30 to 59 years and other group 60 and above year olds. Results: From total of 153 patients included, 87 patients were between 30 and 59 years (middle aged) while 66 patients were 60 years and older (elderly). In both the groups, higher ratios of females persisted (p-0.03). A significant differences between the values were observed only in WBC count (p-0.005) and CRP levels (p<0.001) between middle aged and older age group while all other laboratory variables were found to have an insignificant difference between both the groups. Conclusion: WBC count and CRP level which were observed to be higher among older age patients, compared with middle aged patients. Such alterations in older aged patients ought to be considered when deciding treatment protocols which will have major influence on the prognosis. Keywords: Acute Cholecystitis, C-reactive protein, Systemic Inflammatory Response, Aging Physiology