Background: Single stage bariatric procedures showed some sort of failure in many cases with very high BMI in the aspect of weight regain or initial failure to achieve proper weight loss. So we decided to adopt the concept of 2 staged operations (Sleeve gastrectomy followed by Omega loop or mini gastric bypass) comparing it with single stage (Omega loop gastric bypass) mainly regarding weight loss after 2 years as a primary end point and improvement of different co-morbidities as a secondary end point, in super-super obese patients with BMI >60 kg/m2 . Patients and methods: This prospective randomized study was held in Ain-Shams university hospitals between August 2013 and August 2016 over 28 patients with BMI>60kg/m2,divided into 2 equal groups; (A) underwent mini-bypass only and group (B) underwent sleeve gastrectomy followed 12 months later by mini-bypass, BMI and co-morbidities were assessed before and 2 years after the bypass procedures. Results: In this study, 28 patients were randomly divided into 2 equal groups; group (A) 14 patients who were subjected to MGBP as a solo procedure and group (B) 14 patients who were subjected to SG as a primary stage followed 12 to 15 months by a second stage MGBP.The mean age of group (A) was 37.2±9.95 versus 36.1±8.5 years in group (B), group (A) had 36% (n=5) males and 64% (n=9) females, while group (B) had 57% males (n=8) and 43% (n=6) females. The mean BMI of group (A) was 66.2±3.8 versus 67.07±3.9 in group (B). The BMI decreased from 66.2 to 41.4 in group A, while in group B the mean BMI decreased from 67.07 after sleeve gastrectomy to 48.1 at 12 months, then to 34.4 two years after the second stage. The mean operative time was 118.4±17.9 in group A versus 79.4 ±25.1 in the first stage group B and 100.2±21.6 in the second stage group B. The mean postoperative hospital stay was 4.2±3.07 days in group A, 3.6±2.43 in first stage group B and 4.04±2.5 in second stage group B. Regarding the complications; in group A: we had one case of intra-operative bleeding, another case of post-operative bleeding. Regarding complications in Group B: We had one case of intra-operative bleeding, another case of staple line leak in the first stage, we had one case of port site hernia after the second stage. Conclusion: We found that the two stages concept demonstrated superior results when compared to single stage LMGBP regarding the aspects of weight loss, improvement of comorbidities along with the complication rates. Key words: Bariatric, Sleeve gastrectomy, Mini gastric bypass, BMI.