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Introduction: Laparoscopic Roux-en-y gastric bypass (L-GBP) and Laparoscopic gastric banding (Lap-Band) are the two most commonly performed bariatric operations in the United States. Objective: To compare surgical outcomes of L-GBP versus Lap-band in morbidly obese patients.Methods: Using the Nationwide Inpatient Sample (NIS) database, clinical data of morbidly obese patients who underwent L-GBP or Lap-band from 2006-2008 was analyzed. Outcome measures included patient characteristics, comorbidities, postoperative complications, length of hospital stay (LOS), in-hospital mortality and hospital charges.Results: Of the 254,760 patients, 183,452 patients underwent L-GBP and 71,308 patients underwent Lap-band. The majority of patients were female (L-GBP: 81.0% vs. Lap-Band: 78.3%, p<0.001) and Caucasian (L-GBP: 73.9% vs. Lap-band: 75.5%, p<0.001) in both groups. The mean age in the L-GBP group was lower compared with the Lap-band group (43.4 vs. 45.8 years, p<0.001). Most of comorbidities were significantly higher in the L-GBP group. The overall post operative complications was lower in the Lap-band group (1.39% vs. 4.18%; p<0.001). Specific postoperative complications were all lower in the Lap-band group (UTI, pneumonia, acute renal failure, respiratory failure, myocardial infarction, venous thromboembolism, ileus, abscess, wound infection and bowel obstruction). Compared with L-GBP, patients who underwent Lap-band had a shorter mean LOS (1.16 vs.2.41 days, p<0.001), lower mortality (0.03% vs.0.06%, p<0.001), and lower mean hospital charges ($29,753 vs. $39,570, p<0.001). Conclusion: Compared to laparoscopic gastric bypass, laparoscopic gastric banding is associated with better perioperative outcomes with a shorter length of stay, lower morbidity and lower mortality. Further studies are needed to examine the weight loss outcome between the two operations.