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Background: Gastro-intestinal metabolic surgery has been proposed for the treatment of not well controlled type 2 Diabetes Mellitus (T2DM) patients with a BMI < 35 Kg/m2. This study aims to describe recent experience with surgical treatment of T2DM in Asian centers. Methods: Patients aged 20 to 70 years, with not well controlled T2DM (HbA1C > 7.0%) and BMI < 35 Kg/m2 were included at 5 institutes between 2007 and 2010. The end point is T2DM remission, defined by fasting plasma glucose < 110 mg/dl and HbA1C <6.0%.Results: 163 patients with a mean BMI 30.4 (22-34), age 46.6 (29-67), duration of T2DM 8.8years(0.5-20), C-peptide 2.8ng/ml(0.9-14) and HbA1C of 9.1% (7.0-15) were recruited up to now. Among them, 140(85.6%) received laparoscopic gastric bypass (LGB), 19(11.7%) received laparoscopic sleeve gastrectomy (LSG) and 4(2.4%) received laparoscopic adjustable gastric banding (LAGB). Up to now, 74 patients had been follow-up for at least 12 months. The BMI decreased postoperatively by 19.4% to 24.5. The fasting blood glucose level decreased from 212mg/dL to 117.5 mg/dL, and the HbA1C decreased to 6.3%. The overall T2DM remission rate at 12 months after surgery was 77%(55/74), and was 86.5% for LGB, 61.6% for LSG, 50% for LAGB. Type of surgery, duration of T2DM and C-peptide predict the remission of diabetes after surgery.Conclusion: Gastro-intestinal metabolic surgery safely and effectively eliminated T2DM in patients with a BMI < 35 Kg/m2. Larger and longer study is needed for this trial to confirm the benefit.