- Background Obesity is considered a global epidemic. Until recently, laparoscopic adjustable gastric binding (LAGB) was routinely offered as a means of weight reduction for selected patient populations. Previous case series have documented several pulmonary complications following LAGB. In the current study, we explored the rate of long-term respiratory deterioration associated with LAGB. Methods The study is a historical cohort study of medical records of subjects who underwent LAGB at Soroka University Medical Center in Israel between January 1997 and July 2008. After the exclusion of short-term respiratory events, respiratory morbidity during the three years following the operation was compared with that three years prior to the operation. Subjects whose respiratory status worsened following surgery were further compared with those whose status either remained unchanged or improved. Results The final analysis included 3084 subjects, of whom 709 (22.9%) had documented respiratory morbidity following surgery. Compared to pre-operative respiratory status, respiratory deterioration following LAGB was found in 590 subjects (19.1%). Risk factors associated with the worsening of respiratory status were age ≤28 or ≥46 years (odds ratio [OR] = 1.32, 95% confidence interval [CI]: 1.02–1.71 and OR = 1.42, 95% CI: 1.09–1.85, respectively), female gender (OR = 1.31, 95% CI: 1.06–1.63), and pre-operative documentation of respiratory morbidity. Conclusions The rate of deterioration in the respiratory status observed among subjects who underwent LAGB was high. Consequently, physicians should be aware of the possible link, even years after the surgery, between respiratory symptoms and a history of LAGB.