BACKGROUND:: METHODS:: Between January 1996 and December 2003, 682 patients (570 women, 112 men) underwent SABG implantation. In these patients, there were 60 super-obese patients with a BMI ≥ 50 kg/m. Two groups of patients were analyzed: Group 50 (n = 30 patients) with a BMI 50-54 kg/m and Group 55 (n = 30 patients) with a BMI ≥ 55 kg/m. 13 different surgeons (9 general and 4 bariatric surgeons) performed the SAGB. All data (demographic and morphologic data, operative data, and follow-up data) were prospectively collected in a computerized data bank. RESULTS:: 60 patients (8.8%) out of 682 were super-obese and entered the study. Mean %EWL was 39.2 at 1 year and 60.4 at 4 years, BMI fell from 55.5 to 34.7 at 4 years. The complication rate was 26.7% (16/60). General surgeons 12/60 (20%) had more complications than bariatric surgeons 4/60 (6.7%). In Group 50, mean %EWL was 42.1 at 1 year, 55.9 at 2 years, 61.5 at 3 years and 59.9 at 4 years. BMI fell from 51.8 to 33.2 at 4 years. Postoperative complications occurred in 6/30 patients (20%): pouch dilatation (n=2), band migration (n=2) and band leakage (n=2). In Group 55, mean %EWL was 36.8 at 1 year, 55.3 at 2 years, 55.8 at 3 years, and 59.4 at 4 years. BMI fell from 59.1 to 36.4 at 4 years. Postoperative complications occurred in 10/30 patients (33.3%): pouch dilatation (n=2), band migration (n=3) and band leakage (n=5). There was no mortality. CONCLUSION