Obesity significantly increases the risk of gastroesophageal reflux disease (GERD), often complicating treatment, especially after bariatric surgery. Preoperative assessments in obese patients frequently reveal silent esophageal dysmotility and pathological reflux, underscoring the need for careful evaluation before surgery. Sleeve gastrectomy, the most common bariatric procedure, is often associated with increased GERD due to anatomical changes that elevate intragastric pressure and compromise the gastroesophageal barrier. Alternative procedures, such as Roux-en-Y gastric bypass (RYGB), traditionally effective for GERD, show mixed long-term efficacy, with some patients experiencing persistent or recurrent symptoms. Adjustable gastric banding and single anastomosis gastric bypass may also contribute to GERD through altered esophageal motility or bile reflux. Emerging techniques, like fundoplication-combined sleeve gastrectomy, are being explored to reduce reflux risk. These findings highlight the importance of rigorous preoperative GERD assessment and procedure selection in obese patients to optimize postoperative outcomes.