Twenty-three patients with a mean preoperative weight of 126 kg (100-163) and a mean preoperative Broca index of 1.89 (1.54-2.47) were submitted to gastric banding on account of severe obesity. The operative procedure, complications and results are described. The mean period of observation was 12 months (3/4-42). The mean weight loss after 12 months was 28.5 kg. The greatest weight loss per unit of time occurred during the first six months. In the majority of patients, the weight became stabilized after 12-24 months. Two patients did not lose weight and these were regarded as treatment failures. One patient died three weeks after the primary operation on account of infectious complications of pouch-perforation. Apart from this, no serious complications occurred. The incidence of wound infection was 17%, development of herniae in the scars occurred in 35% and transient symptoms of functional stenosis were encountered in 35%. Despite the high incidence of less serious complications, the authors consider that gastric banding is an employable alternative to intestinal and gastric bypass operations. In future, we will consider perioperative antibiotic therapy although gastric banding is, in principle, a clean operation. In addition, we will reserve gastric banding for patients who do not consume the majority of their calories in fluid form.