Objective To compare the intraoperative blood loss and postoperative stress index levels of patients with acute calculous cholecystitis (ACC) who underwent laparoscopic cholecystectomy within 48 hours and within 48-72 hours. Methods: 102 patients with ACC who underwent laparoscopic cholecystectomy in our hospital from December 2022 to December 2024 were selected as the research subjects. A total of 102 patients were divided into the control group and the study group by the random number table method, with 51 cases in each group. Both groups were treated with standardized laparoscopic cholecystectomy, but different surgical treatment timings were adopted for the two groups. The control group underwent laparoscopic cholecystectomy within 48 to 72 hours after the onset of the disease. The research group performed laparoscopic cholecystectomy within 48 hours after the onset of the disease. The surgery-related indicators, stress indicators [white blood cell count, C-reactive protein (CRP) level] and the incidence of complications of the two groups were analyzed and compared. Results: Compared with the control group, the operation duration, postoperative anal exhaust time and hospital stay of the study group were significantly shortened, and the intraoperative blood loss and postoperative abdominal drainage volume were significantly reduced (P<0.05). Compared with the control group, the white blood cell count and serum CRP level of the study group were significantly decreased on the 1st and 3rd days after the operation (P < 0.05). The incidence of complications in the study group was significantly lower than that in the control group (P < 0.05).Conclusion: Laparoscopic cholecystectomy performed within 48 hours of the onset of ACC in patients can reduce intraoperative blood loss, promote postoperative recovery, relieve stress and reduce complications compared with surgery within 48-72 hours.