Laparoscopic cholecystectomy has become the standard of care for patients requiring the removal of the gallbladder. In 1992, an NIH consensus development conference concluded "laparoscopic cholecystectomy provides a safe and effective treatment for most patients with symptomatic gallstones, laparoscopic cholecystectomy appears to have become the procedure of choice for many of these patients"[1] SAGES first offered guidelines for the clinical application of laparoscopic cholecystectomy in May 1990. These guidelines have periodically been updated and the last guideline in November 2002 expanded the guidelines to include all laparoscopic biliary tract surgery. This document updates and replaces the previous guideline. The current recommendations are graded and linked to the evidence utilizing the definitions in appendices A and B.