Background: The majority of patients undergoing general anaesthesia develop atelectasis, especially following laparoscopic cholecystectomy. During laparoscopic procedures, pneumoperitoneum impairs pulmonary function, resulting in noticeable atelectasis. The lung recruitment technique may reduce postoperative pulmonary complications and hypoxia from atelectasis. Methods: The patients were classified randomly. Group UC did not receive lung recruitment, while Group URM did. All patients underwent ultrasonography at four-time points: T1 - just before anaesthesia induction, T2 – before extubation, T3 - 15 minutes post-extubation, and T4 - 30 minutes post-extubation. Only patients of the URM group have received lung recruitment directed by real-time ultrasound. Ultrasonic scanning showed the absence of collapsed areas following manual adjustment of airway pressure from 10 cmH2O to 20 cmH2O, with a FiO2 of 0.4. After the surgery, patients in both groups were assessed for any ongoing atelectrauma and desaturation. Conclusion: At T3 and T4, the URM group exhibited a significantly reduced aeration loss of 22% and 51%, respectively, compared to the UC group, which showed losses of 53% and 87% (p < 0.01). The URM group exhibited better oxygenation post-surgery than the UC group, with mean SpO₂ values of 98.10 ± 1.744% versus 94.54 ± 1.286% (p = 0.001). The increased alveolar recruitment and gas exchange in the URM group accounted for this outcome. In conclusion, using ultrasound to facilitate lung recruitment may decrease atelectasis during surgeries, improve oxygenation, and enhance pulmonary outcomes in laparoscopic cholecystectomy. Keywords: Perioperative Atelectasis, Lung Recruitment Manouevre, Laproscopic Cholecystectomy