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We report a case of an Australian man in his early 50s, with a BMI of 42.2 kg/m2, who was being worked up for elective bariatric surgery. Initial gastroscopy was unremarkable; however, repeat preoperative gastroscopy 20 months later identified Barrett’s oesophagus. Subsequent histology confirmed oesophageal adenocarcinoma. This report highlights the importance of preoperative workup of patients undergoing bariatric surgery. We advocate for preoperative gastroscopies as a part of the immediate workup prior to any bariatric procedure.