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Introduction: Since the beginning of the COVID-19 pandemic, many patients with clinically acute presentations have been approached differently. The fear for viral transmission along with the short period of study made patients delay their hospital visits and doctors to reassess the approach of certain acute situations. This study aimed to assess the changes in the management of patients with acute cholecystitis before and during COVID-19. Methods: A systematic review of the literature using PubMed (Medline), Scopus and ScienceDirect databases was performed until 01 September 2021. Two kinds of studies were included, those assessing the management of acute cholecystitis during COVID-19 and those comparing periods before and during the pandemic. The outcomes recorded include management approaches, complications and mean length of stay. Results: Fifteen eligible articles were included in the study. During the pandemic, six studies revealed a shift towards conservative management of acute