Bariatric surgery has been emerged as a procedure of choice for morbidly obese patients with or without “Metabolic Syndrome”. Restrictive procedures like sleeve gastrectomy have the significant drawback of decreased long-term efficacy with weight gain in the long run. On the other hand, though RYGB or OAGB (one anastomotic gastric bypass) produces effective long-term weight loss, they are associated with more complications like dumping, marginal ulcers, internal herniation and nutritional deficiencies. In an effort to maximize weight loss with minimal side effects, a new set of procedures are evolving broadly termed as “Sleeve Plus” procedures. This chapter provides a brief overview of “Sleeve Plus” procedures.