The systematic review and meta-analysis investigated gastroesophageal reflux disease (GERD) as a major concern following one anastomosis gastric bypass (OAGB). The analysis of 40 studies involving 17,299 patients revealed that 2% of patients experienced GERD after OAGB, with reflux rates six times higher in revisional OAGB compared to primary OAGB. Medical and surgical treatments were used in 60% and 41% of patients, respectively, with estimated success rates of 85% and 100%.