Laparoscopic Roux-en-Y gastric bypass (LRYGB) was recommended as the gold standard procedure for metabolic and bariatric surgery by the National Institutes of Health in the 1990s and then had been adopted till now, which could effectively control excess weight and treat metabolic diseases relevant to obesity in a long term. The current LRYGB procedure had been performed more than half a century of development and update, and is still constantly evolving. Standardized and precise surgical procedures are of great significance in ensuring treatment effect and reducing the incidence of complications. Thus, the author reviewed the development process of LRYGB, further understanding and emphasizing the importance of standardized and precise surgical procedures.