Bariatric surgery is a rapidly growing discipline in General Surgery. Roux-en-Y gastric bypass (GBP) is currently the most commonly performed bariatric surgical procedure for treatment of morbid obesity in the United States (U.S). The laparoscopic approach to (GBP) has led to a greater acceptance for surgical treatment of morbid obesity by the public and, in return, more surgeons are becoming interested in learning laparoscopic bariatric surgery to meet the high demand. Laparoscopic adjustable silicone gastric banding was approved in the U.S. by the Food and Drug Administration (FDA) for clinical use in 2001, and is emerging as an alternative laparoscopic option in management of morbid obesity. This chapter reviews the indications, techniques, and outcomes of laparoscopic GBP vs. laparoscopic adjustable gastric banding. The advantages and disadvantages of laparoscopic adjustable gastric banding compared to laparoscopic GBP is discussed.