Purpose of the review <p>The global epidemic of obesity presents a challenge to physicians in all fields, as it impacts multiple organ systems and may hinder access to surgical or therapeutic interventions, yet reservations regarding referral for metabolic and bariatric surgery (MBS) persist. In this narrative review, we aimed to examine emerging evidence guiding the shift of what were once considered contraindications, to indications of MBS and to shed light on the future projections of MBS.</p> Recent findings <p>The technical advancements witnessed in the surgical field over the years, as well as the enhancement of preoperative and postoperative patient management, have contributed to significant improvement in the surgical outcomes of MBS. Coupled with the steadily growing body of evidence, the framework of patient selection has shifted and expanded. Additionally, MBS has been increasingly utilized to bridge to other interventions and to improve metabolic dysfunction, regardless of BMI.</p> Summary <p>MBS has transitioned from being viewed as a last-resort intervention to an effective, evidence-based therapeutic modality for obesity and its related medical conditions.</p>