During preoperative assessment of a 44-year-old morbidly obese patient referred to our Center for morbid obesity, a 3-cm submucosal lesion on the subcardial lesser curvature was identified. Abdominal CT scan and EUS with biopsy were suggestive for a well-defined, fibrolipoma. The patient was scheduled for laparoscopic sleeve gastrectomy combined with concomitant transgastric mass resection. Intragastric access was obtained through one 10-mm and two 5-mm gastrotomies along the greater curvature, allowing for operative trocars introduction and stomach insufflation. A clamp placed right after Treitz ligament prevented bowel over-insufflation while maintaining gastric distension. Using energy device, dissection was begun retracting the mucosa in order not to cause inadvertent transmural injury. Once entering the submucosal space, progressive isolation and excision of the lesion was performed using radiofrequency. Intraoperative frozen section analysis confirmed the benign nature of the mass. The gastric mucosa was sealed with monofilament barbed suture. After stomach desufflation, the procedure was completed with standard sleeve gastrectomy. Intraoperative blue-dye test was negative for leakage and a flexible rubber drain was left in place along the suture line. Postoperative gastrograffin swallow confirmed a regularly shaped sleeved stomach without evidence of leak. The patient was discharged on 2^nd postoperative day. Definitive histologic examination of the specimen showed a well-defined, 30-mm submucosal lipoma. To date, outpatient follow-up visits are unremarkable. Laparoscopic transgastric resection of submucosal benign lesions during sleeve gastrectomy is safe and feasible, provided that gastrotomies are left beyond the transection plane.