Endoscopic suturing and gastroplasties represent an important evolution in obesity management, offering a less invasive, effective alternative to traditional weight loss surgery. These procedures reduce the gastric volume or alter its shape, promoting early satiety and limiting food intake. Endoscopic gastroplasties have the advantage of being incisionless, having quick recovery, and having fewer complications, making them an attractive option to patients who may not be suitable candidates or are unwilling to undergo surgery. Several endoscopic gastroplasty options are currently available, along with other newer techniques in development. However, a learning curve exists to gain proficiency with different endoscopic gastroplasty procedures. In this chapter, we describe the method of performing endoscopic gastroplasty using the available suturing platforms and discuss evidence on their efficacy and safety.