Since 1992 we have performed laparoscopic cholecystectomy with 3 trocars (10, 10 and 5 mm) while most surgeons use 4. In our 10 years of experience a total of 1,243 cholecystectomies have been performed with the 3-trocar technique. The overall conversion rate is 0.75%. In 5.7% of cases we used a fourth trocar in order to avoid anatomical difficulties or to perform intraoperative cholangiography. All interventions are technically feasible, even in sclerotic cholecystitis and in emergency operations. We describe this technique which can be considered an economic and cosmetically satisfying alternative, that is safe and effective for the patient and easy to perform for the surgeon.