Obesity and its associated comorbidities, such as diabetes mellitus, hypertension, and cardiovascular disease, are one of today's most pressing health issues and increasing incidence of obesity has marked it a global health challenge. For obese individuals with a high risk of morbidity and mortality who have not lost enough weight with lifestyle and medicinal care and who are experiencing the repercussions of obesity, bariatric surgery should be taken into consideration. Significant weight loss, the remission of coexisting diseases, and an improvement in quality of life are all possible outcomes of bariatric surgery. Laparoscopic procedures account for 96% of all bariatric procedures performed globally, with laparoscopic sleeve gastrectomy (LSG) being the most popular and prevalent. The current gold standard for bariatric surgery is LSG, since it is associated with significant complications such as gastroesophageal reflux disease hence a less invasive replacement for LSG was developed, which is endoscopic sleeve gastroplasty (ESG). In the past few years, ESG, a relatively new technique of endoscopic bariatric therapy, has become more well-known. Several multi-center studies have established the safety, viability, repeatability, and potential for reversibility of ESG. Although it is inferior to LSG in terms of percentage of total body weight loss (TBWL), but within a year of follow-up, it carries a reduced risk of unfavourable outcomes than other surgical procedures. The purpose of this research is to review the available information about advantages and disadvantages of ESG versus LSG.