Aim: To study the circumstances that need the change of laparoscopic cholecystectomy to open cholecystectomy. Material and methods: Patients were categorized into two groups: Group 1, which included patients who underwent successful laparoscopic cholecystectomy (n=50), and Group 2, which included patients who required conversion to open cholecystectomy (n=10).A comprehensive clinical history and previous treatment records were obtained for all patients. A thorough clinical examination was conducted. Preoperative investigations included Complete Blood Count (CBC), Bleeding Time (BT) and Clotting Time (CT), Random Blood Sugar (RBS), Liver Function Tests (LFT), Renal Function Tests (RFT), serum amylase and lipase, urine routine examination, HIV, HBsAg, and HCV screening, Electrocardiogram (ECG), and Chest X-ray (PA view). All patients underwent an abdominal ultrasound, and selected cases also underwent Magnetic Resonance Cholangiopancreatography (MRCP) and Endoscopic Retrograde Cholangiopancreatography (ERCP). Results: Intraoperative findings highlighted several reasons for conversion to open cholecystectomy. Intraoperative complications were the most common reason, accounting for 40% of conversions. Difficult anatomy was the second most common reason, leading to conversion in 30% of cases. Severe adhesions were responsible for 20% of conversions, while unexpected findings, such as malignancy, accounted for 10% of conversions. These findings underscore the importance of intraoperative challenges in determining the need for conversion.Postoperative outcomes demonstrated significant differences between the two groups. The mean duration of surgery was significantly longer for the open cholecystectomy group (85.7 minutes) compared to the laparoscopic group (65.2 minutes), with a p-value of 0.001, indicating a statistically significant difference. Similarly, the length of hospital stay was significantly longer for the open cholecystectomy group, averaging 5.8 days compared to 3.2 days for the laparoscopic group, with a p-value of 0.002. Postoperative complications were more frequent in the open cholecystectomy group (30%) compared to the laparoscopic group (10%), with a p-value of 0.04. Conclusion: The 'gold standard' procedure for cholecystectomy is still laparoscopic cholecystectomy. Conversion from laparoscopic to open cholecystectomy should be based onthe surgeon's sound clinical judgement, not on a lack ofindividual expertise. It should not be viewed as a failure,butratherasanecessary procedurethatwillimprovepatient safety and the likelihood of a positive outcome.