Persistent efforts are being made to reduce operative trauma and morbidity and to improve cosmesis following laparoscopic cholecystectomy. The trend is to reduce the number of incisions, and thus single-incision laparoscopic cholecystectomy (SILC) and natural orifice endoscopic surgery (NOTES) are becoming popular. There is a paucity of studies pertaining to cosmetic outcome after SILC and conventional laparoscopic cholecystectomy in rural Indian population. In the present study, the cosmetic outcome of SILC versus conventional laparoscopic cholecystectomy (CLC) in rural Indian population was evaluated. Sixty patients with gallstone disease were randomly assigned to two groups. In group A (n=30), CLC was performed, while group B (n=30) was subjected to SILC. The cosmetic outcome was evaluated using a body image questionnaire on the 7th and 30th postoperative days. On the 7th postoperative day, the body image score for SILC was 6.23±0.89 and for CLC, 8.26±1.08 (p<0.0001), while the cosmetic score for SILC was 19.56±1.07 and for CLC, 15±1.20 (p<0.0001). On the 30th postoperative day, the body image score for SILC was 5.50±0.68 and for CLC, 8±1.31 (p<0.0001), while the cosmetic score for SILC was 21.13±0.57 and for CLC, 15.63±1.06 (p<0.0001), which favored SILC over CLC. The patient perception and acceptance of SILC was better than that of CLC in terms of cosmetic outcome.