Background: For optimal safety following Laparoscopic Sleeve Gastrectomy (LSG), regular intraoperative endoscopy is recommended to prevent postoperative stenosis and gastric leak. Objective: The aim of the present study is to assess the advantage of using intraoperative endoscopic guidance during sleeve gastrectomy and its efficiency to decrease various complications. Patients and methods: A follow up case series study was conducted at Laparoscopic Gastrointestinal Surgery Unit, General Surgery Department of Zagazig University Hospitals. The study included 18 cases planned for laparoscopic sleeve gastrectomy. Results: Operative time ranged from 2 to 3 hours with mean of 2.19 hours. Concerning intraoperative complications, no patient had bleeding. One patient had leak which was corrected by reinforcement suture. Another patient had twisting which was corrected. Postoperatively, all patients did not develop leak, bleeding or obstructive symptoms. Two (11.1%) patients had postoperative vomiting which was corrected by prescribing antiemetics. There were no statistically significant associations between incidence of intra/postoperative complications and either age, weight, body mass index, operative time or comorbidities. Conclusion: Important complications after LSG, such as bleeding or even deadly ones like gastric leak, can be avoided with the help of an endoscope, which is used during the calibration of the gastric sleeve.