Introduction: Although laparoscopic sleeve gastrectomy (LSG) is an effective treatment for morbid obesity, the effects of LSG on gastroesophageal reflux disease (GERD) are controversial. Although improvement of GERD symptoms following LSG has been reported in some studies, others have shown a 9–34.6 % increase in the prevalence of GERD symptoms during the first year following LSG.   Aim: This study was aiming to evaluate the changes of GERD symptoms and erosive esophagitis (EE) in morbidly obese patients who underwent LSG.   Patients and methods: Pre-and post-operative details of forty morbidly obese patients (body mass index (BMI) more than 40 kg/m2  or 35 kg/m2  with other comorbidities) with and without GERD who underwent laparoscopic sleeve gastrectomy and were followed up in Ain Shams University hospitals between September 2014 and May 2016 were recorded.   Results: After surgery, significant decreases were reported in mean body mass index (44.3±3.8 vs. 36.5±5.3 kg/m2). Conversely, an insignificant increase was observed in the prevalence and severity of GERD symptoms and EE after LSG. 1 patient (20%) developed denovo symptomatic GERD within the 6 months follow-up.   Conclusion: Although LSG can achieve significant weight loss and improvement of comorbidities in severely obese patients, the prevalence and severity of GERD symptoms and EE increase after the operation mandates that it should be carefully investigated pre-operatively and other bariatric surgery options should be considered.