Objective: To compare the efficacy and safety of laparoscopic cholecystectomy (LC) in treatment of acute calculous cholecystitis (ACC) at different timing within early stage. Methods: The literature of clinical studies comparing the efficacy and safety of LC at different timings for ACC publically published before April 2017 was searched from national and international databases. Meta-analysis was performed on some relevant clinical variables by using RevMan 5.3 software. Results: Fifteen studies were included, involving 16 389 patients, of whom, 13 417 cases underwent LC within 48 h after onset and 2 972 cases underwent LC within 48 to 72 h after onset. The results of Meta-analysis showed that, the operative time (MD=–11.33, 95% CI=–17.26––5.40, P=0.0002), intraoperative blood loss (MD=–24.60, 95% CI=–45.83––3.36, P=0.02), incidence of bile duct injury (OR=0.48, 95% CI=0.26 0.90, P=0.02) and open conversion rate (OR=0.56, 95% CI=0.43–0.74, P<0.0001) were reduced in patients undergoing LC within 48 h compared with those undergoing LC within 48 to 72 h. The differences in the length of hospital stay, overall incidence of complications and the incidence of bile leakage, intestinal obstruction, postoperative intra-abdominal hemorrhage, wound infection, abdominal infection, pulmonary infection and incisional hernia showed no statistical significance between the two groups of patients (all P>0.05). Conclusion: In ACC patients, LC has better efficacy and safety when performing within 48 h after onset.