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Endoscopic evaluation of patients preparing to undergo bariatric procedures is an important component in optimizing overall care. Although colonic pathology exists in bariatric patients as it does in the general population, this chapter focuses on the role of preoperative endoscopy involving bariatric surgical anatomy of the foregut. The role of endoscopy in bariatric surgery begins well before a patient undergoes an index surgical procedure. Many centers have adopted a policy of screening patients endoscopically before index bariatric procedures to decrease the risk of missing foregut pathology that should be addressed before bariatric surgery.