Laparoscopic sleeve gastrectomy (LSG) is gaining popularity as a primary, staged and revisional operation for its proven safety and simplicity, as well as short-term and mid-term efficacy. Some evidence has shown that sleeve gastrectomy and similar procedures can be complicated by significant post-operative reflux symptoms. With an intact pylorus, severely restricted stomach capacity, and physiologically disrupted motility possibly creating stasis, one would expect that LSG would not be likely to relieve heartburn reflux symptoms, as does LRYGB. Methods: This was a randomly selected prospective study carried out on morbidly obese patients presented to Kasr El-Aini teaching hospital during the period from January 2013 to March 2014, where sixty patients underwent sleeve gastrectomy. These patients grouped into two groups according to the starting point of resection of the stomach; group (A) started 3cm from the pylorus towards the gastro-esophageal junction and group (B) 6cm from the pylorus. The decision to do 3 cm resection or 6 cm resection randomly selected. These patients followed over a period of 6 months for post -operative nausea; vomiting and reflux symptoms and their weight loss. Results: The overall patients’ weight loss percentage ranged from 30 to 86.9 % excess body weight loss with a mean of 60 %. In group A (3 cm), patients’ weight loss percentage ranged from 31.2 to 86.9 % excess body weight loss with a mean of 60.9%, however, in group B (6 cm), patients’ weight loss percentage ranged from 30 to 83.5 % excess body weight loss with a mean of 61.1%. In this study, (41.7%) of patients lost (40-60%) of their excess body weight within 6 months without significance to any group or by other mean (91.7%) of patients lose > 40% of their body weight at 6 months with no significance to 6 cm or 3 cm groups as seen from P-value 0.610. There was no major complications (e.g.; leakage, bleeding, pulmonary embolism or death). However, minor complications in the form of nausea, vomiting and reflux were more with 3 cm group (96.6%) as compared to 6 cm group (67.9%). There was a strong significant difference between both groups can be seen in the P-value (0.003). Conclusion: The majority of patients (88.3%) were satisfied from the procedure and its results with no statistically significant difference between both groups in terms of weight loss, decreased appetite or patient satisfaction. Key words: Sleeve gastrectomy, Morbid obesity, Bariatric surgery.