Gastric remnant obstruction after gastric bypass may occur secondarily to sequelae from duodenal ulcers, pyloric stenosis, or vagus nerve damage. We present the case of a 28 year old female with a weight of 260 lbs and BMI of 46 who underwent a laparosocopic gastric bypass in August 2004. Ten months after surgery, an abdominal CT scan confirmed a complete obstruction of the gastric remnant. The patient underwent a percutaneous gastrostomy under CT guidance. A contrast study performed through the gastrostomy tube revealed a complete gastric remnant obstruction at the level of the pylorus. Thirteen months alter, it was decided to perform a laparascopic pyloroplasty. The patient was placed in the supine split-leg position. The pylorus was identified and dissected with the first portion of the duodenum. An opening using the harmonic scalpel was created at the pylorus, which had a very thick prominent wall. This incision was extended longitudinally proximal and distal to the pylorus. The pyloroplasty was closed transversely using a running suture of maxon 3-0. Laparoscopic pyloroplasty is a good alternative in the treatment of gastric remnant obstruction.