This review has summarized the concept of anesthetic management for laparoscopic adjustable silicone gastric banding. We have discussed the pathophysiology of obesity and how it affects different body systems. Different options for treatment of obesity have been discussed with showing the indications, contraindications and side effects of each. We also discussed laparoscopic surgery, its advantages, and the common problems facing the anesthesiologist as pneumoperitoneum, hemodynamic problems, ventilatory problems and positioning problems. Finally, we have highlighted laparoscopic adjustable silicone gastric banding as the most recent option for treatment of obesity with showing the anesthetic implications during this procedure and the immediate postoperative period.