In order to study the clinical characteristics of patients with acute acalculous cholecystitis (AAC) in China, we retrospectively analysed the epidemiology, clinical manifestations and treatment of hospitalised cases with AAC in our hospital between January 1991 and October 1998, and compared the results with western reports. Most AAC cases in our series were younger than 60 years, and there was no significant difference between males and females. Their clinical manifestations were usually not serious. Only one patient suffered complications. The rate of complications and mortality was lower than those in western countries. All patients were treated and recovered; none needed an emergency operation and there were no deaths.