Abstract: Objective To investigate the safety and clinical efficacy of main gallbladder artery ligation-free in laparoscopic cholecystectomy. Methods The clinical data of 84 patients with acute calculous cholecystitis admitted to Xuzhou Central Hospital from July 2016 to December 2017 were retrospectively analyzed. The observation group (n=42) underwent laparoscopic cholecystectomy without ligation of the main gallbladder artery, while the control group (n=42) underwent routine laparoscopic cholecystectomy. Results The operation was successfully completed in both groups without conversion to laparotomy. The amount of bleeding in the observation group was significantly less than that in the control group (P<0.05), and the total incidence of complications in the observation group was significantly lower than that in the control group (P<0.05). Conclusions Laparoscopic cholecystectomy without ligation of the main gallbladder artery is safe and effective in the treatment of acute calculous cholecystitis, which is worthy of clinical application.