Objective: To study the effect of laparoscopic cholecystectomy and atropine intramuscular injection in the treatment of acute cholecystitis in the elderly. Methods: From January 2018 to January 2019, 100 elderly patients with acute cholecystitis were selected from our hospital. The patients were divided into experimental group (receiving atropine intramuscular injection) and control group (receiving laparoscopic cholecystectomy). The effect of the two methods was compared by comparing the treatment effect of the two groups. Results: The results showed that: the Visual Analog Score (VAS) between the two groups before the treatment, the score of VAS, Self-rating Depression Scale (SDS) and Self-Rating Anxiety Scale (SAS) before and after treatment were not significantly different (P>0.05). The score of SAS and SDS after treatment in the two groups was significantly lower than that before treatment (P<0.05); the score of vas in the experimental group was significantly higher than that before treatment (P<0.05); and the score of vas in the experimental group was significantly higher than that before treatment (P<0.05) The difference was statistically significant in the control group (P<0.05). Conclusion: Laparoscopic cholecystectomy and atropine intramuscular injection are usually used to relieve the pain in the elderly patients with acute cholecystitis. The disadvantages of atropine intramuscular injection and laparoscopic cholecystectomy are that the pain relief effect is poor, the advantages are that there are fewer adverse reactions after treatment, but both of them have better dredging effect on the patients with depression and anxiety. Because of the low physical quality of the elderly patients, atropine intramuscular injection should be the main treatment.