Although considered a common bariatric procedure, laparoscopic adjustable gastric banding (LAGB) is associated with high rates of weight loss failure and long-term complications. The purpose of this study was to re-assess the safety and outcome of conversion of failed LAGB to laparoscopic sleeve gastrectomy (LSG). One hundred and nine patients underwent conversion from LAGB to LSG (78 females, mean age 43 +/- 11.3 years, mean BMI 42.4 +/- 7.4 kg/m(2)). Patient demographics, obesity-related co-morbidities, BMI before and after the procedure, post-operative complications, and length of hospital stay were documented. All cases were completed laproscopically, with 88% (n = 96) performed in a single stage. Fourteen patients developed early post-operative complications (12.8%), including two leaks and three post-operative bleeding. There were no mortalities in this series. Average BMI at least 1-year following surgery was 33 +/- 5.3 kg/m(2) (excess weight loss (EWL) = 53.7%). Our data suggests that conversion of failed LAGB to LSG is both safe and effective. Randomized controlled studies comparing conversion of a failed LAGB to sleeve gastrectomy versus other bariatric operations are necessary to clarify the optimal conversion procedure.