Background: Bariatric surgery is the only effective long-term treatment for morbid obesity. We compared long-term results of the vertical banded gastroplasty (VBG) and biliopancreatic diversion with duodenal switch (DS). Quality of life (QoL), weight loss (WL), and reoperation were evaluated. Methods: This is a retrospective study of 85 of 129 patients with VBG and 49 of 743 patients with DS, with follow-up >5 years. Mean preoperative BMI of the VBG patients was 48.8 kg/m(2) and for the DS patients was 50.3 kg/m(2). Results: Percent excess weight loss (%EWL) at 5 years for VBG patients was 56.4% and for DS patients 70.6% (P<0.0001). 8 VBG patients (9.4%) and 1 DS patient (2.0%) required re-operation due to failure of the technique. None of the VBG patients could eat a normal diet, while 80% of the DS had no restriction in the quality of their intake. Conclusions: At 60 months follow-up, only the DS patients fullfilled the ASBS requirements of %EWL >50 in over 75% of the patients.