Laparoscopic sleeve gastrectomy is gaining popularity as a treatment of morbid obesity. It is a relatively new procedure with a postoperative follow-up not exceeding 5 years. The natural orifice transluminal endoscopic surgical procedures are also gaining in popularity, and we are now experiencing the first transition from animal to human trials. We describe the first sleeve gastrectomy surgery for morbid obesity using the vagina as the natural orifice in the form of a hybrid natural orifice transluminal endoscopic surgery transvaginal sleeve gastrectomy, including the short-term outcomes and complications.