This chapter focuses on aspects of bariatric surgery unique to the adolescent population. It discusses the health consequences of obesity in this age group, the indications for bariatric surgery, and pre-operative and post-operative management. Multiple studies suggest long-term health is significantly compromised due to persistence of adolescent overweight into adulthood. Obesity during some of the most psychosocially formative years of life can have significant impact on how children and adolescents adapt as effective members of society. The main bariatric surgical procedure used in the adolescent population today is Roux-en-Y gastric bypass (RYGB). In 1991, the National Institutes of Health published consensus guidelines for bariatric surgery in adults. Adolescents who have failed multiple non-surgical weight loss attempts may be considered candidates for surgical intervention. Vitamin and mineral supplementation is required in order to optimize bone growth in growing adolescents and to avoid nutritional consequences.