Laparoscopic adjustable gastric banding is a highly effective treatment for obesity, with the broadest indications and lowest rate of early complications among the various bariatric surgeries commonly performed in the United States. Weight loss is accompanied by improvement or resolution of multiple comorbid conditions in addition to improvements in quality of life. The technique of band insertion has evolved over time, resulting in dramatic improvements of outcomes. As with any bariatric surgery, optimal results require evidence-based perioperative management, long-term routine followup, and the participation of committed patients both before and after surgery. This review encompasses the indications, technique, outcomes, and complications associated with this operation.