Introduction Morbid obesity has taken the form of an epidemic in the USA with over 11.5 million affected nationwide. The vertical band gastroplasty (VBG) first described by Mason in 1982, had been the most commonly performed bariatric procedure in US. However, it lost its popularity as a solo procedure over the last decade due to high incidence of failure and re-operation rate (30%) for reflux complications. This work reviewed 194 patients who had VBG with sleeve gastrectomy (SG) and the incident of pre-operative morbidities along with the post-operative progress of their weight loss.Methods A retrospective review was done on records of 194 patients who underwent Lap VGB-SG from June 20, 2002 to August 20, 2006, at a single institution. Using Excel software a performa was designed to standardize data entry on all 194 cases. Pre-operative parameters included age, sex, BMI and presence of co-morbidities namely GERD, hiatal hernia, hypertension, diabetes, hyperlipidemia, asthma, sleep apnea and depression. The post-operative data collected were anastomosis leakage, port hernia, wound infection, nausea and vomiting persisting for more than 3 weeks, weight loss.Results The age range of this group was 17 to 68 years with the mean of 43. There were 26% males and 74% females. The pre-operative mean BMI was 49 ranging from 33 to 90. The incidents of co-morbidities were as follows: GERD:48%, hiatal hernia(less than 5 cm; 26% and more than 5cm; 1%), hypertension:56%, diabetes:25%, hyperlipidemia:47%, asthma:20%, sleep apnea:59% and depression:35% and 61% of patients had more than 3 conditions. Operative time ranged from 104 to 234 minutes, averaging 125. The post-operative weight lost at 1month, 6months, 1year and 2years was 18%, 47%, 65%, and 66% respectively. There was 0% anastomosis leakage, 0% port hernias and no death in the follow up to date. Wound infection occurred in 1%. The conversion rate was 0%. The most common complication was nausea and vomiting (8%). No patient developed dumping syndrome.Conclusion Laparoscopic SG with VBG can be safely and rapidly performed for the treatment of morbid obesity in both male and female patients for a wide range of age groups. It was well tolerated by patients with more than three co-morbidities and was also well received by patients with small hiatal hernias. There were no major complications or morbidities, including dumping syndrome associated with it. Further follow up is needed to evaluate the long term outcome in these patients.