Objective: To analyze the reasons for conversion from laparoscopic cholecystectomy (LC) to open surgery and the related factors. Methods: The clinical data of 3 849 patients undergoing LC from January 2010 to December 2015 were retrospectively analyzed. Results: Among the 3 849 patients, 39 cases (1.01%) were converted to open surgery, and there was no significant difference in conversion rates among years during 2010 to 2015 (P=0.982). The reasons for open conversion included unclear anatomy of Calot’s triangle in 16 cases, severe abdominal or pericholecystic adhesions in 14 cases, Mirrizi syndrome in 3 cases, cystic artery bleeding in 2 cases, and bile leakage, common bile duct injury, cholecystoduodenal fistula and gallbladder cancer in 1 case each. Thirty-three patients underwent early open conversion, and 6 patients underwent intermediate or late conversion, and the open conversions in 5 cases in the latter were performed due to intraoperative complications that included cystic artery bleeding in 2 cases, obscure Calot’s triangle after gallbladder rupture and resultant dense adhesions in 1 case, common bile duct injury in 1 case and bile leakage in 1 case. Gender, age and course of disease were influential factors for conversion of LC (all P<0.05). The incidence of short-term postoperative complications of conversion of LC by senior surgeons was significantly lower than that by junior surgeons (P=0.043). Conclusion: There is a certain conversion rate during LC, difficulties in dissection of Calot’s triangle and severe abdominal or pericholecystic adhesions are main reasons for open conversion, and early open conversion is recommended in those with relevant influential factors to ensure surgical safety.