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The purpose of this paper is to study the causes of leaks following sleeve gastrectomy (SG).Pubmed was searched during January 2016 for publications reporting leak after SG. A total of 205 publications were identified, of which 17 papers were selected.In about 3018 patients, reinforcement was used compared with 4595 patients, in whom no reinforcement was applied; both groups were representing matched bariatric populations. The use of reinforcement/buttressing has resulted in different rates of leaks ranging from 0% to 3.9%; whereas with no reinforcement/buttressing, the leak rate was 0.16% to 3.5%. The use of reinforcement/buttressing did not result in reduction of leak to a statistical significance although the trend was suggesting so (P=0.06), whereas no reinforcement/buttressing did not statistically increase the leak rate (P=0.10).No statistical significant difference of leak with or without reinforcement. This mean case complexity and surgical technique and experience are the sole factors for leaks following SG.