Background <p>Laparoscopic cholecystectomy remains the gold standard and minimally invasive surgery for management of gallbladder disease, offering safe outcome. However, significant disparities exist across low -middle income countries. This study presents surgical outcomes of laparoscopic cholecystectomy performed at a high-volume general hospital with a hepatobiliary surgeon in Ethiopia.</p> Methods <p>The institutional based cross-sectional medical record review conducted was carried out at Addis Hiwot General Hospital, Addis Ababa. Based on previously published literature, a structured questionnaire was created for this study with the goal of collecting thorough data. Frequencies and percentages were used to summarize categorical variables, and the χ² test was used to compare groups. The Shapiro-Wilk test was used to evaluate the distribution of continuous variables. Means and standard deviations (SD) were reported for data that was normally distributed; medians and interquartile ranges (IQR) were used for data that was not normally distributed.</p> Results <p>A retrospective analysis of 424 patients who had laparoscopic cholecystectomy revealed that the female-to-male ratio was roughly 5:1, and the mean age was 42·2 years (SD 12·7). 91% of cases involved elective procedures. In 62·0% of patients, symptomatic cholelithiasis (biliary colic) was the most common indication, followed by chronic calculous cholecystitis (22·9%). The conversion rate to open cholecystectomy was 3·5% overall. The overall mean hospital stay was 21&#xa0;h (SD 9.7), with a shorter duration observed in elective laparoscopic cholecystectomy. Within 30 days, 2.8% of patients experienced postoperative complications; no deaths were reported.</p> Conclusion <p>The study demonstrated that laparoscopic cholecystectomy remains to be a safe procedure with low morbidity, conversion rate and no mortality. Even at general hospital in a low-income country. These findings underscore the urgent need for investment in surgical infrastructure.</p>