Globally, the burgeoning burden of obesity is aggravated by the limitations of available treatment options. Bariatric surgery, aimed at weight loss, falls short of addressing certain patient groups, such as those who are overweight but only mildly obese. This necessitates the need for alternative procedures to cater to the needs of patients with obesity. In recent years, endoscopic sleeve gastroplasty (ESG), a minimally invasive weight loss procedure, has emerged as an alternative to bariatric surgery. Evidence from studies detailing ESG outcomes could help us understand the implications for its future usage and guide further developments.