<p>Sleeve Gastrectomy (SG) is the most common bariatric procedure worldwide. Its relative high safety profile is one of the reasons for its popularity. Despite this, SG may lead to short and long-term morbidity, sometimes severe, which may negatively impact patients’ quality of life (QoL). Data on this long-term impact of surgical complications is limited. Our objective is to determine the long-term outcomes and overall QoL in patients who had major postoperative complications after SG. This is a retrospective analysis of patients who underwent SG between the years 2010–2013 at single-tertiary center and completed a 10-year follow-up period. Data of patients with major complications was captured and matched to patients with an uneventful postoperative course based on a propensity score. Data withdrawn included weight trends, QoL measures, and obesity associated medical problems. Thirty patients with major complications after SG were matched to a control group of 45 patients with an uneventful postoperative course. There was no difference in baseline patient characteristics. Long-term weight outcomes were similar—with mean excess weight loss (EWL%) of 63.33% in the study group versus 59.93% in the control group (<i>p</i> = 0.55) and mean total weight loss (TWL%) of 27.4 ± 7.66%, in the study groups versus 25.28 ± 14.14% in the control group (<i>p</i> = 0.49). Interestingly, QoL measures showed significant impairments in the study group, with a BAROS QoL score of − 0.06 compared to 0.72 in the control group (<i>p</i> = 0.001). Despite the presence of major postoperative complications after SG, long-term weight loss outcomes were not significantly different between the two groups; however, they are associated with a long-term decline in QoL. Further studies are needed to explore and clarify this data.</p>