Background: The laparoscopic cholecystectomy is a safe and effective medical intervention; however its impact on health care costs remains controversial. The aim of this prospective study was to compare costs and related socio-demographic factors that affect the economic outcome of laparoscopic [LC] and open cholecystectomy [MC]. Methods: Sixty-seven patients (pts) treated with either LC or MC cholecystectomies were studied. Direct [fixed and variable] costs were obtained for each treatment group during pre-, intra- and post-operative care as well as indirect cost due to loss of productivity. To obtain data, a structured questionnaire comprising of economic and socio-demographic variables such as gender, age, profession and permanent health insurance plan, was developed. Results: The total direct cost was similar in the two treatment groups [1.676±148 Euros in the LC group versus 1.701±390 Euros in the MC group, p-value =0.645]. The mean intra-operative cost was significantly lower for the LC method [402.7 Euros in the MC group versus 249.7 Euros in the LC group, p <0.001] as well as the mean operative time [107 min in the MC group and 75 min in the LC, p<0.001] and the length of hospital stay [5.06± 6 days for the LC method versus 10.72± 7.3 days for the MC method; p<0.001]. The indirect cost due to loss of productivity was significantly less in the LC group than in MC method because of substantial earlier return to work rate. The total [direct and indirect] cost was slightly less in LC method [1.986, 4±246, 9 Euros for the LC method versus 2.372,2±610,5 Euros for the MC method]. Conclusion: Laparoscopic cholecystectomy is slightly less expensive approach compared to open surgery for treatment of gallstone disease. However, when indirect costs are calculated, LC method is even more a cost saving intervention.