Vertical banded gastroplasty-gastric bypass is a surgical technique combining the advantages of the vertical banded gastroplasty with those of gastric bypass. The procedure was performed on 148 morbidly obese individuals: 83% were female, and 17% were male. Ages ranged from 15 to 64 years, with a mean age of 35. Mean percentage weight was 215% of ideal. The vertical banded gastroplasty is constructed by creating a 10 cc vertical pouch along the lesser curvature with a 5.5 cm supporting band. The pouch is fashioned in a way that the lower portion is free and mobile. This free segment of stomach is anastomosed by triangulation to a Roux-en-Y loop of jejunum, which is brought up in a retrocolic, retrogastric fashion. With 100% follow-up in the 19 patients who have reached 1 year, average excess weight loss has been substantial. There was one early postoperative complication requiring surgery. Two patients required late revisional operations. Vertical banded gastroplasty-gastric bypass is a relatively simple procedure to perform and has a low rate of complications. Gastric bypass in combination with a small banded pouch along the lesser curvature should result in substantial and permanent weight loss.