ABSTRACT Background: Morbidity increases for obese patients when laparoscopic cholecystectomy is performed at the same time as bariatric surgery. Objective: The aim of the current study was to evaluate the safety, efficacy, and clinical outcome of simultaneous cholecystectomy (CC) during laparoscopic sleeve gastrectomy (LSG) obese patients with asymptomatic cholelithiasis. Patients and methods: A case series was carried out on 18 morbidly obese patients in the Department of General Surgery, Hepatopancreatico and Biliary Surgery Unit at Zagazig University Hospital for surgical management. During the period study, all patients with LSG and CC were postoperatively followed-up with for 6 months. Results: The mean duration of surgery for both LSG and CC was 108.50 (SD 9.364) min (range, 90-125 min). There were 2 (11.1%) females complicated with gall stone spillage, while, there were 2 (11.1%) male and female complicated with gall bladder bed bleeding. All cases completed the procedure laparoscopically without conversion to open, visual analogue scale (VAS) revealed a mean score of 5.28 (SD 1.708). According to patient’s satisfaction, there were 10 (55.6%) patients with good satisfaction and 8 (44.4%) patients with excellent satisfaction. Only 5.6% discharged in the 1st day, 33.3% of patients at the 2nd day, 44.4% at the 3rd day and 16.7% patients discharged at the 4th postoperative day. Conclusion: CC is safe and practical during LSG and is appropriate for all patients with established gall bladder. CC can be done during LSG without increasing morbidity or duration of hospital stay.