Gastroesophageal reflux disease (GERD) is a condition seen commonly in the bariatric surgery population. Although some operations, such as Roux-en-Y gastric bypass, are known to be associated with a reduced incidence of reflux postoperatively, the prevalence of GERD after laparoscopic sleeve gastrectomy (LSG) may be increased by 2.1% ~ 34.9% [1]. In addition, it is still controversial for the treatment of medication-refractory GERD after LSG. Here, we report the surgical management of a patient, suffering from acid reflux, heartburn, and vomiting, with a modified laparoscopic Belsey (Mark IV) fundoplication 2 years after a successful LSG operative for obesity.