Objective To explore the clinical characteristics of laparoscopic cholecystectomy (LC) in the elderly and evaluate the safety of LC. Methods A total of 182 patients who underwent LC in our hospital from Jan. 2020 to Jan. 2022 were enrolled. The clinical data of the course of disease, underlying diseases, operation time, blood loss, complications, length of hospital stay and other clinical data of the elderly group (age≥60 years) and the non-elderly group (age＜60 years) were compared, and the characteristics of gallbladder diseases and the experience of safe operation in the elderly were summarized. Results There were 80 elderly patients, including 34 males and 46 females; there were 102 non-elderly patients, including 53 males and 49 females. Compared with the non-elderly group, the operation time in the elderly group was significantly longer (［69.04±31.57］ min vs ［55.29±21.22］ min, P＜0.05), with more underlying diseases (71.25%［57/80］ vs 20.59%［21/102］, P＜0.05), more patients with previous upper abdominal surgery［7.50% (6/80) vs 0 (0/102), P＜0.05］, more intraoperative blood loss (30.00［10.00, 30.00］mL vs 20.00［20.00, 50.00］mL, P＜0.05), and greater total length of hospital stay (［6.10±3.97］ d vs ［4.89±2.53］ d, P＜0.05). There was no significant difference in postoperative complications or postoperative hospital stay between the 2 groups (all P＞0.05). Postoperative pathology showed that 2 cases in the elderly group were gallbladder adenomatous hyperplasia with high-grade intraepithelial neoplasia, without gallbladder malignant tumor. Conclusion There are many underlying diseases in elderly patients. Controlling the surgical indications properly, careful operation and nursing are important factors for the success of LC in the elderly.