Abstract: Objective: To analysis of diagnosis and treatmen of acute acalculous cholecystitis (AAC) in aged patients. Methods: Of the 42 patients selected, 31 underwent cholecystectomy, 3 cholecytostomy and exploration of common bile duct, 8 partial cholecystectomy. Results: No death and serious complications occurred within these patients. There was 1 case of post operative death due to septic shock andmultiple organs failure. Conclusions: AAC often occurred in elderly people and its clinical features included complicated pathogenesis, rapid progress and highmortality.