Background <p>Obesity has become a growing health concern in Algeria. Its prevalence continues to rise, and related metabolic complications are increasingly common. Although metabolic and bariatric surgery (MBS) is widely regarded as the most effective treatment for severe obesity, its use remains limited and largely confined to private practice.</p> Methods <p>This narrative review compiles data on the epidemiology of obesity in Algeria, the evolution of bariatric practice, and the barriers that restrict access to MBS.</p> Results <p>Obesity rates have nearly doubled over the past two decades, yet fewer than 1,000 bariatric operations are performed each year, mostly sleeve gastrectomies (SG) in private centers. GLP-1 can achieve temporary weight loss but is restricted by high cost and poor availability. The recent publication of Algeria’s first National Guide for Obesity marks an important policy step, but training programs, a national registry, and team-based care are still missing.</p> Conclusion <p>Algeria should make Metabolic and Bariatric Surgery (MBS) a priority in its fight against obesity. Using the new national guidelines as a starting point, the country now needs to develop specialized training programs for surgeons, set up a national registry to track patient outcomes, and secure insurance coverage for the procedure.</p>