The EndoBarrier (duodenal-jejunal bypass liner) became available in 2009 as an endoscopic treatment method for obesity and type 2 diabetes mellitus (T2D). The treatment results in significant weight loss and improvement of the obesity-related morbidities such as T2D, non-alcoholic steatohepatitis, hypertension and other cardiovascular diseases. However, unexpected complications such as liver abscesses can occur, in addition to expected adverse events such as bleeding, obstruction, and migration. The incidence of these complications is low however, and to date no treatment-related mortality has occurred with the use of EndoBarrier. After more than 3800 procedures, it can be concluded that the EndoBarrier is safe and effective. This treatment option can be applied in patients with a BMI over 30 kg/m2 and also obese patients with T2D who do not wish to undergo, or are not fit for, a surgical procedure.