Aims: To study the optimal timing of surgery for gallbladder neck stone impaction with acute cholecystitis. Methods: A (surgery within 48 hours) B (48 hours ~ surgery); comparison of each clinical data between the groups: preoperative conditions (duration and degree of pain, duration and peak of fever; degree of limited peritonitis; peak of WBC and GRAN ratio); severity of imaging (gallbladder size, thickness of gallbladder wall, surrounding exudate); degree of intraoperative difficulties (degree of surrounding adhesions, presence or absence of purulent bile, gallbladder triangular dissection is difficult); postoperative recovery (complications, drainage, postoperative days to discharge, patient self-satisfaction) RESULTS: Group A had milder preoperative symptoms and relatively easy surgical operation, fewer complications, faster postoperative recovery, and high patient satisfaction. CONCLUSION: Gallbladder neck stone impaction with acute cholecystitis should be operated as early as possible within 48 hours.