Vertical banded gastroplasty (VBG) is the construction of a small vertical pouch using a linear stapler, with addition of a Marlex band placed through a window formed by a circular stapler. Compared to gastric bypass, VBG maintains a more normal anatomy of the upper gastrointestinal tract. However, due to poor long-term outcomes and a high percentage of patients requiring revisional surgery, most bariatric surgeons have abandoned VBG as a primary bariatric procedure. Early complications include acute gastric distention and gastric leaks. Late complications include mesh migration or erosion, stomal stenosis, staple-line disruption, and gastrogastric fistulas. The most common revision is to Roux-en-Y gastric bypass (RYGB). There are reports of other revisions, such as the vertical banded gastroplasty−gastric bypass (VBG-GB), re-VBG, RYGB-on-VBG, VBG to duodenal switch, VBG to biliopancreatic diversion, VBG to sleeve gastrectomy, VBG to adjustable gastric band, and VBG reversal, as well as endoscopic alternatives.