Gastroesophageal reflux disease (GERD) is highly prevalent in obese patients and is closely related to weight changes. However, according to different types of bariatric and metabolic surgery, it may exacerbate or even induce new-onset GERD depending on the type of bariatric and metabolic surgery performed. Therefore, GERD remains a significant concern for patients undergoing bariatric and metabolic surgery, particularly sleeve gastrectomy (SG). Affected patients not only experience declining physical health but also face psychological and emotional distress, leading to decreased social functioning. The incidence of GERD after SG surgery is caused by the interaction of many factors such as anatomy, physiology, and physics, including the shape of the sleeve stomach, the degree of intraoperative injury to the esophageal sphincter, and whether esophageal hiatal hernia is complicated. Treatment options may include lifestyle modifications, medications, interventional therapies, and/or revisional surgery.