Small bowel obstruction (SBO) after bariatric surgery is well documented. Although infrequent, it can be associated with considerable morbidity and mortality. The laparoscopic approach to Roux-en-Y gastric bypass (LRYGB) has gained widespread popularity for the treatment of morbid obesity since its first description in 1994. One of the theoretical advantages of a minimally invasive technique is reduced intraabdominal adhesions and, consequently, diminution in the incidence of SBO. However, the laparoscopic approach demonstrates a similar rate of obstruction to the open procedure. In this review, an electronic literature search was undertaken of Medline, Embase, and Cochrane databases for the period January 1990 to October 2006 on the history, presentation, clinical evaluation, preoperative diagnostic techniques, and management of SBO after LRYGB compared to the open approach.