Abstract Background: Laparoscopic sleeve gastrecomy is the most popular bariatric procedure with good outcome and acceptable complications (bleeding, leakage, stenosis or twist). Aim of Study: To evaluate the role of omentopexy rein-forcement of staple line in reducing postoperative leakage, bleeding and gastric twist. Patients and Methods: This is a prospective cohort study conducted at Ain-Shams University Hospitals, in the period From May 2017 to November 2020. Four hundred morbid obese patients were recruited for this study. Ethical approval was obtained from the Ethical Committee of Ain Shams University Hospitals, and informed written consents were obtained from all patients. Results: Our study included 200 patients who underwent Laparoscopic sleeve gastrectomy, one hundred patients un-derwent LSG without omentopexty (group A) and the other one hundred patients underwent LSG with omentopexy (group B). As regards the age, group A (control group) mean age of 35.74±7.88 while group B (omentopexy group) mean age of 35.6±7.85. The mean BMI 40.95±5.25 in group A while 40.94±5.02 in group B. Three cases of group A (1.5%) while group B had no cases of postoperative leakage with p-value is 0.24. Two cases of group A had postoperative bleeding (1%) while it did not happen in group B with P value is 0.499. Gastric twist had happened in only 1 case of group A (0.5%) while did not happen in any cases of group B, P value is 1. The mean operative time in group A 46.08±10.95 minutes, while 67.49±9.19 minutes in group B with p-value 0.00. Conclusion: LSG with omentopexy reduce rate of post-operative complications (bleeding, leakage and gastric twist) but need longer time than conventional LSG.