Abstract: Nowadays, the incidence of obesity and related metabolic diseases is increasing around the world, which seriously endangers the human health and the quality of life. Obesity has become the most prominent public health issue in the time. With the rapid development of surgical treatment of obesity combined with type 2 diabetes mellitus, bariatric surgery has gradually evolved into a new important branch of upper gastrointestinal surgery or gastrointestinal surgery, that is bariatric and metabolic surgery. To date, bariatric surgery has entered in China since twenty years ago. Following the steps of the rapid development of bariatric and metabolic surgery in the world, bariatric surgery has embarked on a solid and steady journey of development through seizing the opportunity, finding the right direction. On the way forward in the past twenty years, Chinese bariatric and metabolic surgery has not only faced setbacks and confusion, but also gained experience and lessons; it has encountered bottlenecks in its development and provided evidences from China. The number of surgeons in bariatric surgery is still limited compared with a large number of obese people. Therefore, there will be opportunities and challenges coexisting in the future. How to continuously improve the therapeutic effect of surgery, train more professional practitioners, break through the bottleneck, and seek faster development will be an important research topic in metabolic and bariatric surgery with the scientific evidencebased medicine accumulating.