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Bariatric surgery in superobese (BMI > 50 kg/m2) and super-superobese (BMI > 60 kg/m2) patients can be a formidable technical and therapeutic challenge because these patients often present multiple medical, surgical, and anesthetic risks. Only a few dedicated reports on different surgical options in this kind of patient population are available. The aim of this study is the evaluation of laparoscopic adjustable gastric banding (LAGB) results in an unselected populations of super-superobese patients operated during the last 4 years. Super-superobese (BMI > 60 kg/m2) patients who underwent LAGB were recruited from the prospective database of our institution. LapBand® System (Allergan, Irvine, CA, USA) was positioned in all cases via pars flaccida, 1–2 cm below the gastroesophageal junction and fixed anteriorly with three non-absorbable stitches. The band was not filled at the time of surgery. Operative time, co-morbidities, laparotomic conversion, intra- and postoperative complications, mortality, and weight-loss-related parameters were considered. Data were expressed as mean ± standard deviation, except as otherwise indicated. From January 2003 to December 2006, 823 patients underwent a bariatric surgical procedure, 95 of whom (11.5%) were BMI > 60 kg/m2 (59 F/ 36 M; mean BMI, 62.5 ± 4.2; range, 60.1–77 kg/m2; mean age 38.5 ± 13.5, range 18–61 years old). Mortality, intraoperative, and 30-day major complications were absent. One or more preoperative co-morbidities were diagnosed in 90 of 95 (94.7%) patients. After 1 year, co-morbidity-free patients increased from five of 95 (5.3%) to 27 of 95 (28%; p