A relative contraindication to laparoscopic adjustable gastric banding (LAGB) has been gastroesophageal reflex disease (GERD). GERD is a common pre-operative co-morbidity in the morbidly obese patient seeking weight loss surgery. We examined all patients who have had GERD pre-operatively and followed them after LAGB. All patients who have symptoms of GERD underwent helicobacter pylori testing and upper gastrointestinal endoscopy if warranted. Asymptomatic ulcers and patients with h. pylori were treated with medications before initiation of surgery. All patients received a laparoscopic anterolateral fundoplication as part of their LAGB surgery. All hiatal hernias encountered were repaired at the time of surgery.Results: Out of 128 patients who had pre-operative GERD underwent LAGB surgery without any complications, 126 patients had an immediate resolution of their symptoms. These patients were able to wean off of their pre-operative proton pump inhibitors. Long term results greater than one year revealed that 5 patients developed recurrent symptoms. Three of the 5 patients had recurrent h. pylori infection and two patients had concentric dilatation of the pouch requiring removal of the LAGB device.Conclusion: GERD in the morbidly obese patient can be treated adequately with the LAGB procedure. When long term recurrence of symptoms occur, h. pylori needs to be tested. Concentric dilatation of the proximal pouch has been observed in patients with massive weight loss (greater than 100 lbs.) and a thick fibrous scar has been observed during removal of LAGB suggesting a foreign body reaction.