Background: This study is based on the access technique for the creation of pneumoperitoneum in the operative procedure of laparoscopic cholecystectomy. This technique is a crucial step in this operative procedure. Aim: The specific aim is to study the efficacy of closed and open methods for creating pneumoperitoneum in laparoscopic cholecystectomy by comparing their outcomes and complications. Materials and methods: Our study is a prospective observational study for 2 years January 2021 to January 2023 of cases done in our facility at central and southern Ondo, Nigeria. Consecutive patients with cholelithiasis who consented to laparoscopic cholecystectomy were recruited into the study using a purposive sampling method after applying the exclusion criteria. The patients demographics and comparative variables were imputed into a proforma which was analyzed using SPSS version 26 (IBM incorporated Chicago, Illinois). Results: Of the 50 patients under study there were 4 males (8%) and 46 females (92%). The mean age was 45.74 ± 6.2 years. About 28 underwent the closed method of access while 22 underwent the open method. Minor complications like gas leaks during the procedure were observed more in the open method group. Other complications such as visceral and vascular injury and conversion to open surgery after the initial access were not observed in both groups. However umbilical port-site hematoma, umbilical port-site infection, and incisional hernia were observed in the open access method during follow-up period. The time taken to close abdominal ports wound was almost the same in both groups. However, the mean operating time was significantly less in the closed-access method. In general, the length of hospital stay in both groups was not significantly different. Conclusion: Even though both access methods are safe, the closed method is more efficacious than the open method.