Good outcomes are usually reported by patients after laparoscopic sleeve gastrectomy (LSG), especially during the short- and intermediate-term follow-up. The long-term outcome is insufficiently in literatures. We conducted this study to determine the long-term outcomes of LSG regarding weight loss, weight regain, and the effect on obesity-associated comorbidities. Patients and methods: This retrospective study presents the data of 517 patients who underwent LSG between 2012 and 2020. Data were collected regarding weight loss, weight regains, and changes in obesity-associated comorbidities at 2, 4, 6, 8, and 10 years after the procedure. Results: The maximum weight loss was obtained at two-year follow-up. The mean %EWL had mean values of 69.14%, 63.71%, 58.86%, 53.13%, and 47.3% at the scheduled follow-up visits, respectively. The resolution and improvement of hypertension and diabetes showed good outcomes at the initial two follow-up visits. Nonetheless, recurrence of both diseases was notedat the subsequent visits. The incidence of worsening symptoms continued to increase throughout the follow-up visits. Revisional surgery was performed in 45 patients (8.7%), after a mean period of 5.98 years following the primary LSG procedure. The indications were weight regain (73.33%), failure of comorbidity resolution (20%), and intractable reflux (6.67%). Conclusion: Although LSG is associated with great weight loss and comorbidity resolution at the short- and intermediate-term follow-up, long-term follow-up showed a weakening of these effects manifested in decreased %EWL, recurrence of comorbidities, weight regain, and need for revisional procedures.