Background/aim: The incidence of acute cholecystitis (AC) increases with age, and aging is also one of the poor prognostic factors. Aging is related to altered physiology, so diseases may show different characteristics in elderly patients. We aimed to investigate the differences between the main characteristic features of AC in elderly and nonelderly patients. Materials and methods: In this retrospective study, patients who had a diagnosis of AC were included and divided into two groups of people aged <65 years or &#8805;65 years. Laboratory and ultrasonographic findings related to AC were compared statistically between elderly and nonelderly patients. Results: The data of 305 patients diagnosed with AC were recorded. Patients in the nonelderly group were more likely to be female, but in elderly patients the sex distribution was similar. There were no significant differences with respect to liver function tests and ultrasonographic findings at the time of admission between the elderly and nonelderly groups. However, the elderly group had a significantly higher rate of patients with an elevated white blood cell count and higher C-reactive protein values than the nonelderly group. Conclusion: Aging is related to altered immunologic and pathophysiologic processes. Thus, age and baseline comorbidities influence overall mortality rates. Efforts should be made to understand disease mechanisms and minimize avoidable harms.