Abstract Background Acute pancreatitis is an inflammatory disease of the pancreas with acute biliary pancreatitis (ABP) accounting for 75% of cases. Current recommendations favour early laparoscopic cholecystectomy (LC) for mild acute gall stone pancreatitis during the same index admission to prevent recurrent attacks reported to be as high as 18–61% in various studies. Endoscopic sphincterotomy in cases who are unfit for cholecystectomy during the index admission or there is delay in cholecystectomy due to logistics may benefit from ES while waiting for elective cholecystectomy, in terms of reducing the number of recurrent attacks and decreasing morbidity. Methods A total of fifty-seven (57) patients of mild to moderate ABP were included in this study and were divided into three groups undergoing LC within 5 days of admission, ES within 7 days of onset of pain abdomen and LC within 4 weeks of initial illness and LC after 8 weeks of attack in the three respective groups and evaluated for level of difficulty of cholecystectomy, recurrent attacks and associated morbidity. Results Difficult LC in terms of adhesions, calots anatomy was seen in 17(n=57) patients. 13(n=38) patients had recurrent attack of pancreatitis during the waiting period for cholecystectomy, 2(n=19) in the ER group and 11(n=19) in the conservative management group, with all patients in the conservative group having more than 2 recurrent attacks. Conclusion LC in early period is a safe, effective, in patients of gallstone induced pancreatitis. ES is well tolerated and viable alternative to cholecystectomy to prevent recurrent pancreatitis until definitive treatment.