Purpose Early laparoscopic cholecystectomy is considered best practice in the treatment of acute gallstone pancreatitis. However, there is debate regarding the timing of surgery during the index admission. We reviewed some of the factors that can help determine the timing of early cholecystectomy. Methodology Electronic medical records were retrospectively reviewed for all adult patients with acute gallstone pancreatitis over a 2-year period at a tertiary centre, who underwent laparoscopic cholecystectomy during the same admission. Patient outcomes and complication rates were compared to whether they had met our preoperative study criteria of being opioid-free, tolerating solid diet, and serum C-reactive protein level ≤100mg/L. Results A total of 199 patients were included in our study. 83 (42%) met all three of our preoperative criteria, while the remaining 116 (58%) did not meet at least one of these criteria. The median time to surgery was 4 days (IQR3-6) and median length of stay was 6 days (IQR4-8), which was similar between the two study groups. There was no significant difference found in rates of postoperative surgical site infection (2.4% vs 4.3%, p=0.46), haematoma (2.4% vs 2.6%, p=0.94), bile leak (0% vs 1.7%, p=0.14), and intra-abdominal collection (1.2% vs 3.4%, p=0.30). There were also similar rates of further interventions, including endoscopic retrograde cholangiopancreatography (ERCP) (7.2% vs 6.0%, p=0.73), interventional radiology (1.2% vs 0%, p=0.19), and return to theatre (2.4% vs 2.6%, p=0.94). There was no postoperative venous thromboembolism or mortality reported in either study group. Conclusion This study highlights the relatively low complication rates of early laparoscopic cholecystectomy for acute gallstone pancreatitis. Determining the optimal timing to proceed to surgery can be difficult, with multiple clinical and biochemical factors to consider. Better understanding these preoperative factors can likely further improve patient outcomes.