A total of 641 laparoscopic cholecystectomies performed between January 1, 1991 and December 31, 1991 were reviewed to compare the results of Potassium Titanyl Phosphate (KTP/532) laser versus monopolar electrosurgery in laparoscopic cholecystectomy. KTP laser dissection was used alone in 199 cases (31%), and monopolar cautery was used in 442 (69%). During this same time period, 41 additional procedures were excluded because of conversion to open cholecystectomy. Procedures in which both modalities (N = 24) were used were also excluded from the study. Modality choice was dependent upon operating surgeon's preference. Data were analyzed with student t-test, chi-square with Yates correction, stepwise linear regression analysis, and correlation matrices. Five (2.5%) patients had five major complications when KTP laser dissection was used and 34 (7.7%) patients had 42 major complications when monopolar electrosurgical dissection was used (p < 0.05). Postoperative hospital stay with the KTP/532 laser dissection group was 1.4 +/- 0.06 days and for the monopolar electrosurgical dissection group it was 1.7 +/- 0.08 days (p < 0.05). The duration of the procedures was identical with either modality. The use of the KTP laser for dissection of the gallbladder during laparoscopic cholecystectomy may be a safer procedure with significantly decreased complication rates and savings in length of hospital stay. Although initially a more expensive procedure, the savings in length of hospital stay and treatment of complications may offset the initial expenditure and be worthwhile.