Laparoscopic sleeve gastrectomy (LSG) is considered a straightforward procedure but the surgical technique is one of the major determinants of the success of this procedure. We describe a 3-port approach to LSG that was adopted in 750 consecutive cases. The LSG was completed with 4 cartridges in 712 cases (95%) and was associated with a 4.8% rate of complications including a 2.4% rate of leak. The surgical technique is described in detail and the inherent advantages are discussed.