Laparoscopic gastric band surgery is on the rise in response to our obesity epidemic. More than 80% of the procedures are performed in women, with a marked proportion of these being of childbearing age. Not surprisingly, there are an increasing number of women entering pregnancy with a gastric band in place; a world of the unknown to obstetricians. This is further compounded in the setting of pregnancy, with alteration to one’s abdominal anatomy that can precipitate band complications. This case demonstrates one such complication, band slippage, triggered initially by persistent hyperemesis from the ‘fake’ smaller stomach created by the gastric band, which subsequently caused the band to slip and lead to upper gastrointestinal obstruction and malnourishment. The dilemma facing both obstetrician and gastric surgeon was a unique one; deflate the band, continue the pregnancy on transparental nutrition or premature delivery. A literature review was conducted on laparoscopic banding in pregnancy, concluding that there is no consensus on the management of the bariatric obstetric patient. This case therefore raises some important learning points that are invaluable given the growth of bariatric surgery facing us over the next decade.