Background: The most effective therapy for morbid obese patients now available is bariatric surgery, which can help patients losing weight effectively and sustainably while also improving their quality of life and comorbidities associated with obesity. Worldwide, the one anastomosis gastric bypass (OAGB) technique is one of the most performed bariatric surgeries. Objective: The study's objective was to compare the outcomes of the OAGB, with those of the single anastomosis sleeve jejunal bypass (SASJ) as a new method in terms of weight reduction, operating time, postoperative complications, and impact on comorbidities three years following surgery. Patients and Methods: This prospective randomized study included a total of 200 morbidly obese patients undergoing OAGB or SASJ for the treatment of morbid obesity and comorbidities, attending at Department of the bariatric Surgery, tertiary care hospital, Ain Shams University Hospitals. The included subjects were divided into two equal groups: 100 each; SASJ and OAGB groups. Results: The operative time was prolonged in SASJ group (104.7 minutes) compared to OAGB group (76.4 minutes). OAGB group had significant lower Body mass index (BMI) mean as well as significant lower body weight mean at all time intervals through the 3 years follow up. OAGB group had 92% resolution of comorbidities while 68% of SASJ group had resolution. Post-operative HbA1c showed rapid improvement in both groups. Concerning the post-operative complications, no statistically significant differences. Conclusion: It could be concluded that OAGB and SASJ bypass are efficient bariatric surgeries for weight reduction and comorbidities resolution with favorable outcomes in OAGB group.