Aim: Comparative analysis of preoperative ultrasonography reports with intraoperative surgical findings in laparoscopic cholecystectomy. Materials and methods: This cross sectional observational study was done in the Department of General Surgery, Sharda Hospital, School of Medical Sciences & Research (Greater Noida) from December 2020 to July 2022. 90 male and female patients with equal to or more than 18 years of age who are diagnosed with Cholelithiasis by Ultrasound whole abdomen and undergoing Laparoscopic Cholecystectomy will be included in the study. Results: In this study, in 21 patients, it took 90 minutes or more to operate. Out of which 7 patients had Adhesions and none of them were reported in USG, three had Mucocoele and none were reported in USG, one had impacted stone which was reported in USG, one had Empyema which was missed on USG. In two patients haemorrhage from liver bed was responsible for increased duration of surgery. The complications were reported among 20.9% subjects with Adhesions among 13.2%, Mucocoeleamong 3.3%, Empyema among 1.1% and Impacted stone among 1.1%. Out of 10 patients in which preoperative USG report showed increased GB wall thickness, four (40%) had adhesions, one had mucocele (10%) and one had empyema (10%). The average time taken in these 10 patients was 92 minutes. Conclusion: The most reliable indicator of a challenging laparoscopic cholecystectomy was gall bladder wall thickness, which was impacted gall stones and mucocoele which can lead to increase in time taken for the surgery. Though impacted stones were a good indicator of difficult laparoscopic cholecystectomy, it may often be missed on USG.