Abstract: Bariatric and metabolic surgery has been developing in China for 20 years, with late beginning, high starting and rapid development. As the number of metabolic surgeries is increasing year by year, all kinds of clinical and basic researches are gradually increasing, and China has become an important force to promote bariatric and metabolic surgery in the world. At the era of rapid development of bariatric and metabolic surgery, there are many problems such as identifica-tion of surgical indications, selection of surgical methods, prevention and treatment of postoperative complications. The authors conduct an in-depth discussion the problems in the development of bariatric and metabolic surgery, in order to promote rapid and heath development of the new subjects.