Bariatric surgery in children, a medical intervention typically reserved for severe cases of obesity, represents a multifaceted approach aimed at addressing the complex challenges posed by excessive weight in the Paediatric population. This specialized surgical procedure involves modifying the gastrointestinal tract to achieve significant and sustained weight loss, thus mitigating the numerous physical and psychological health risks associated with childhood obesity. Children undergoing bariatric surgery often grapple with comorbidities such as type 2 diabetes, hypertension, sleep apnoea, and joint problems, necessitating a comprehensive and tailored treatment plan. The decision to pursue bariatric surgery in children is a carefully considered one, involving a thorough evaluation of the child's physical and emotional well-being, family dynamics, and the exhaustion of non-surgical interventions. Common bariatric procedures in children include sleeve gastrectomy, gastric bypass, and adjustable gastric banding, each with its unique considerations and potential benefits. The surgery itself is just one facet of a broader, holistic approach to Paediatric obesity management, which includes preoperative counselling, postoperative follow-up, nutritional guidance, and ongoing psychological support. The goal is not only to induce weight loss but also to promote long-term lifestyle changes that enhance overall health and well-being. Despite the potential benefits, the ethical considerations surrounding bariatric surgery in children are paramount, with experts emphasizing the importance of thorough informed consent, careful patient selection, and close monitoring of growth and development. The evolving landscape of Paediatric bariatric surgery underscores the need for ongoing research, collaboration between medical disciplines, and a nuanced understanding of the unique challenges presented by childhood obesity to ensure the optimal health outcomes and improved quality of life for affected children.