Introduction: Current international guidelines recommended routine pre- and post-operative endoscopy for sleeve gastrectomy (SG) due to potential risks of Barrett oesophagus (BO) and oesophageal adenocarcinoma. However, the benefit of routine pre-operative endoscopy remains unclear. Aims: To determine whether pre-operative endoscopy results in material changes to the surgical plan or difference in post-operative endoscopic outcomes. Method: Part 1 – We compared endoscopic outcome between the post-SG endoscopic outcome between those who had pre-operative endoscopy (Pre-op, N=222) and those who did not (NoPre-op, N=872). Part 2 - We prospectively analysed consecutive endoscopies pre-SG (N=509) vs. post-SG (N=1094). Regression analysis used to determine factors associated with BO. Results: Part 1 - Preop group's BO rate was 4.9%, oesophagitis 22.2%. Patients from both groups underwent laparoscopic SG. Post-operative endoscopy performed at 1.9+/-1.2 vs. 2.1+/-4.5 years (p=0.468). There was no difference in prevalence of BO (4.1vs.3.7%, p=0.788), oesophagitis (p=0.474), severity of oesophagitis (p=0.466), or hiatus hernia (p=0.619). Part 2 - Post-operatively, hiatus hernia (p<0.001), cardia effacement (p<0.001), and bile stasis (p<0.001) were more prevalent. The prevalence and severity of oesophagitis were similar (p>0.05). Barrett's rates were similar (3.9%vs.3.7%, p=0.860). Conclusion: No material changes to the surgical plan occurred due to the pre-operative endoscopy findings. Post-operative endoscopic outcomes were favourable regardless of having pre-operative endoscopy. Therefore, selective pre-operative endoscopy screening for those symptomatic or high-risk for BO maybe more helpful.