Objectives: To highlight spectrum of findings on Magnetic Resonance Cholangiopancreatography (MRCP) in patients with acute cholecystitis. To determine length of hospital stay in operated cases. Method: This retrospective observational study was conducted in Radiology department at our hospital in Dhahran, from August 2016-2018. All patients who presented with acute cholecystitis, obstructive liver pattern or deranged liver tests, and underwent MRCP (on a 1.5 Tesla scanner) were evaluated. Patients with chronic cholecystitis, previous hepatobiliary surgery, pregnant patients and those contraindicated to MRI were excluded. Patterns of MRCP findings were categorized as: (i) acute cholecystitis with normal CBD, (ii) acute cholecystitis with dilated CBD and cause identifiable, (iii) acute cholecystitis with dilated CBD and cause not identifiable. Any associated biliary ductal variants or anomalies (e.g., pancreas divisum, choledochal cyst, low insertion of CBD) were also documented. Operated cases were followed to determine length of hospital stay after open or laparoscopic procedures. Chi-square and t-test were used to determine association. Results: Of the 104 patients, majority (60%) were females. The mean age was 43 years. Two-thirds of patients were having normal CBDs (68.3%), while nearly one-third (31.7%) had dilated CBDs, and half of these (16.4%) showed an identifiable cause of obstruction. Thirteen patients (12.5%) had associated anomalies. The length of hospital stay was seen significantly less in laparoscopic than with open cholecystectomies (p=.0005). Conclusion: Magnetic resonance cholangiopancreatography is helpful to identify causes and anomalies in patients with acute cholecystitis patients having deranged or obstructive liver function.