Background: Gallstones are one of the most frequent causes of stomach pain. The only effective treatment for gallstones that cause symptoms is cholecystectomy. The present study was conducted to assess predictive factors determining conversion to open cholecystectomy in patients undergoing laparoscopic cholecystectomy. Materials & Methods: 70 patients with acute cholecystitis of both genderswere subjected to ultrasonography. The percentage of conversions to open cholecystectomy, and the cause of the conversions was recorded. Results: Out of 70 patients, males were 30 and females were 40. Out of 70 cases, 10 were converted to open cholecystectomy. Causes were post ERCP status in 1, bile duct injury in 1, extensive intra-abdominal adhesions in 2, frozen/Inflamed Calot’s triangle in 4 and cholecystoduodenal/colic fistula in 2 cases. The difference was non- significant (P< 0.05). Age group (years)<60 comprised of 36 in LC and 6 in OC group and >60 years had 24 in LC and 4 in OC group. There were 23 male and 7 females in LC group and 37 male and 3 females in OC group. Gall bladder wall thickness > 5mm was seen in 3 in LC and 5 in OC group, previous acute cholecystitis was seen in 2 in LC and 5 in OC group, Post ERCP status was seen in 5 in LC and 1 in OC group and previous abdominal surgery was seen in 4 in LC and 2 in OC group. The difference was significant (P< 0.05). Conclusion: Male gender, gall bladder wall thickness greater than 5 mm, and the existence of past episodes of acute cholecystitis were independent predictors of the decision to switch from laparoscopic to open cholecystectomy.