The anesthesiologist may be requested to deal with several challenges in morbid obesity, especially combining obstructive sleep apnea hyponea syndrome. It is a significant important to perform a thorough preoperative evaluation to identify potential risk factors related to anesthesia and adequately prepare for perioperative management. MO affects multiple vital organs. The preoperative evaluation of the consequences of obesity not only involves case history and physical examination, but also should focus on respiratory and cardiac systems. As intubation and maintenance of oxygenation may be particularly challenging, various strategies should be presented. In addition, different pharmacokinetic and pharmacodynamic drug regimen, perioperative and postoperative management may be also challenging. We reported a case, a patient who suffered from morbid obesity and underwent laparoscopic adjustable gastric banding, and analyzed anesthetic management.