We present a case of technical cause of bowel obstruction after construction of jejunojejunostomy. This video is meant to be instructional, especially within a training program. The patient is a 58 year old woman with body mass index of 42 who underwent laparoscopic Roux-en-Y gastric bypass (RYGB). Post operatively she did well and discharged on post-operative day (POD) 1. That evening she had symptoms of abdominal pain, fevers, and nausea. She presented late afternoon on POD 2 with epigastric tenderness on exam without peritonitis, mild leukocytosis without tachycardia. CT scan showed a high grade bowel obstruction with massively dilated gastric remnant, biliopancreatic and roux limb with decompressed distal small bowel. The patient was taken quickly for exploratory laparoscopy. Decompression of the gastric remnant was performed with suction aspirator. The twist at the jejunojejunostomy was seen where the proximal aspect of the roux limb was used to create the jejunojejunostomy. This twist caused a complete obstruction and unable to be salvaged. Therefore division of the jejunojejunostomy was performed with three blind limbs and reconstruction performed of roux limb back in continuity and new jejunojejunostomy creation 20 cm distal to prior anastomosis. Patient was discharged on POD 5 due to pain control issues.Conclusion:Early small bowel obstruction due to technical misconstruction of jejunojejunostomy is uncommon but serious complication. Bariatric surgeons must be aware of the potential misconfigurations and operative management to correct the error.