Purpose: Laparoscopic cholecystectomy (LC) in elderly patients poses unique challenges due to increased comorbidities and surgical risks. This study examines outcomes of patients aged ≥80 years undergoing LC. Methodology: A retrospective analysis of 116 patients aged ≥80 years who underwent LC between January 2020 and December 2024 was conducted in Cairns Hospital. Data collected included patient demographics, surgical characteristics and outcomes. Results: The mean age was 84 ± 3.3 years, with an equal sex distribution (54.3% male). Males were more likely to experience complications (p=0.035). The mean surgical time was 135.15 ± 56 minutes, with prolonged operative duration significantly associated with complications (p<0.001). The mean length of stay was 5.7 ± 5.6 days, with longer hospitalization correlating with higher complication rates (p=0.005). 28.4% (33/116) required ERCP. The median ASA was 3. Emergency procedures constituted 87% of cases and were associated with a significantly higher complication rate (p=0.002). No significant differences were observed regarding age, ASA or surgeon experience. The overall complication rate was 20% (23/116), with an average Clavien-Dindo score of 1.7. ICU admission was required in 3% of cases, 2.6% underwent subtotal cholecystectomy, and 3.4% required conversion to open surgery. No mortality was recorded. Conclusion: LC in elderly patients is associated with a significant risk of complications, particularly in emergency settings and with prolonged surgical time. Optimizing patient selection and perioperative management may improve outcomes.