This chapter provides an in-depth review of the role of self-expandable metallic stents (SEMS) in managing complications following vertical sleeve gastrectomy (VSG), with a focus on leaks and stenosis. SEMS have become a cornerstone in the endoscopic management of early postoperative leaks, particularly when leaks are large, associated with stenosis, or unsuitable for internal drainage. Advances in stent design, such as fully covered bariatric-specific SEMS, have reduced migration and improved leak resolution. While sleeve stenosis is less commonly treated with stents, they may serve a role in select refractory cases. The chapter also addresses common complications, including migration and erosion, and emphasizes the importance of patient monitoring and timely intervention. Novel technologies such as over-the-scope suturing, lumen-apposing metal stents (LAMS), and specially designed stents like the Luso-Cor™ are discussed for their potential to optimize outcomes. A treatment algorithm is provided to guide clinical decision-making in the management of post-VSG leaks.