Metabolic and bariatric surgery has developed from the original purpose solely for weight reduction to the treatment of obesity related glucose, lipid metabolism and endocrine disorders. The indications for the surgery are constantly expanding, and the treatment scope covers type 2 diabetes, non-alcoholic fatty liver disease, sleep apnea syndrome, and so on. In addition, the body mass index requirement for eligibility of the surgery has been constantly reduced. At the same time, the connotation is constantly being enriched along with profound understanding of conventional surgical procedures including Roux-en-Y gastric bypass, sleeve gastrectomy, adjustable gastric banding, as well as biliopancreatic diversion with duodenal switch surgery and one anastomosis gastric bypass surgery. However, the future of metabolic and bariatric surgery also faces the challenges of weight-loss surgical devices and endoscopic treatment innovations.