Abstract: Objective To investigate the short-term clinical efficacy of laparoscopic sleeve gastrectomy with transit bipartition (LSG-TB) in the treatment of super obese patients. Methods Retrospective analysis was conducted on 34 super obese patients who underwent LSG-TB at the Affiliated Hospital of Xuzhou Medical University from January 2019 to February 2024. Clinical data were collected, and all patients were followed up for one year after surgery. The perioperative complication rate, weight loss and glycemic control efficacy, and postoperative complication were analyzed. Results The mean preoperative BMI of the 34 patients was (53.4±3.4) kg/m², which decreased to (47.2±3.1), (42.8±3.2), (37.7±3.9), and (31.8±5.1) kg/m² at 1, 3, 6, and 12 months postoperatively, respectively, with statistical differences compared with baseline (P<0.01). Among 19 patients with type 2 diabetes mellitus before surgery, 17 achieved complete remission and 2 partial remission at 12-month follow-up. Hypertension, hyperlipidemia, and obstructive sleep apnea-hypopnea syndrome present before surgery were all significantly improved. Only one case of intestinal obstruction occurred in the perioperative period, which improved with conservative treatment. No severe complications such as infection, reoperation, deep vein thrombosis, or perioperative death were observed. Conclusions LSG-TB is safe and effective in the treatment of super obese patients, with significant weight loss and glycemic control benefits.