Cholecystectomy has been widely performed in the management of acute cholecystitis, and laparoscopic cholecystectomy has been increasingly adopted over the past 15 years. Although laparoscopic cholecystectomy is well established as a treatment for symptomatic gallstones, acute cholecystitis was initially considered a contraindication to laparoscopic cholecystectomy. It was considered a contraindication to laparoscopic cholecystectomy because of the technical difficulties in operating in acute cholecystitis and the ensuing complications, including bile duct injury, intestinal duct injury, and liver injury. However, laparoscopic cholecystectomy is now considered safe when surgical specialists are skilled in its application. Laparoscopic cholecystectomy has been found to be superior to open cholecystectomy as a treatment for acute cholecystitis due to lower complication rates, shorter postoperative hospital stays, faster recovery, and earlier return to work. However, laparoscopic cholecystectomy has not become routine in the treatment of acute cholecystitis because the timing and choice of approach for surgical treatment of patients with acute cholecystitis remains a controversial issue. This guideline describes the timing of surgical treatment of acute cholecystitis through a one-question-and-answer format. 1. When is the best time to perform cholecystectomy for acute cholecystitis? Cholecystectomy is best performed early after admission to the hospital (recommendation level A). 2. Which surgical procedure should be adopted: laparoscopic or open cholecystectomy? Laparoscopic cholecystectomy is preferable to open cholecystectomy. (Recommendation grade A). 3.What is the best time for surgical treatment according to the severity grade of acute cholecystitis? Mild (grade I) acute cholecystitis: early laparoscopic cholecystectomy is preferred. Moderate (grade II) acute cholecystitis: early cholecystectomy is performed. However, if the patient has severe local inflammation, early gallbladder drainage (percutaneous or surgical) is feasible. As early cholecystectomy may be difficult, medication and delayed cholecystectomy are necessary. Severe (grade III) acute cholecystitis: organ dysfunction and severe local inflammation, emergency management with gallbladder drainage and/or cholecystectomy should be performed. Delayed cholecystectomy should be performed. 4.What are the complications to be avoided in abdominal cholecystectomy? Bile duct and other organ damage. 5.The best time for intermediate open abdomen? To avoid injury, physicians should not hesitate to intermediate open abdomen when they encounter difficult laparoscopic cholecystectomy. 6. What is the best time for cholecystectomy after percutaneous hepatic puncture gallbladder drainage? Early cholecystectomy at first admission is appropriate (recommendation grade B). 7. What is the best time for laparoscopic cholecystectomy after endoscopic stone extraction in patients with combined gallbladder and common bile duct stones? Early endoscopic stone extraction followed by early cholecystectomy during the same hospitalization is preferable. (Recommendation grade B).