Background: The aim of the study was to investigate how acute cholecystitis has been treated in Denmark after implementation of laparoscopic cholecystectomy. Method: An analysis of data from the mandatory Danish National Patient Registry, which covers all public hospitals in Denmark , was performed. The annual number of cholecystectomies and the annual number of cholecystectomies performed for acute cholecystitis from 1996 to 2003 were registered. Separate data for open and laparoscopic operations were obtained and compared. Results: An increase in the number of cholecystectomies for acute cholecystitis from 13.6 in 1996 to 17.1/100,000 in 2003 was observed (P < 0.05). The proportion of patients treated for acute cholecystitis in relation to all cholecystectomies performed declined from 0.14 in 1996 to 0.12 (P < 0.05), and 41% of cholecystectomies performed for acute cholecystitis were completed laparoscopically in 1996 compared with 61% in 2003 (P < 0.05). For laparoscopic cholecystectomies performed for other reasons than acute cholecystitis, the corresponding rates were 78% and 83%, respectively (P < 0.05). Conclusion: The number of patients having cholecystectomy for acute cholecystectomy has increased significantly, as has the rate of laparoscopically completed cholecystectomies for acute cholecystitis, but 39% still have an open procedure. There is therefore room for further reduction in open cholecystectomy in order to provide more patients the benefits of minimal invasive surgery.