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In the last 10 years, gastric bypass has become an increasingly common operation performed by general surgeons. The complications resulting from this procedure can be life-threatening and are often difficult to diagnose, particularly in the immediate postoperative period. We detail a case of thyrotoxicosis manifesting on postoperative day 1 which presented with symptoms mimicking an anastomotic leak. The patient underwent a negative laparoscopy before the thyroid dysfunction was diagnosed. There is no evidence that bariatric surgery carries a greater risk of postoperative thyrotoxicosis than any other non-thyroid operation. Many of the symptoms of thyrotoxicosis, however, are similar to those of other surgery-related complications, and it should be immediately considered in the differential diagnosis of a postoperative bariatric patient with tachycardia and fever. Failure to rule out this condition may lead to unnecessary surgery.