Background: The objective of this study was to evaluate sleeve gastrectomy plus jejunal bypass (SG-JJB) for type 2 diabetes mellitus (T2DM) in Chinese patients with a body mass index (BMI) ≥32.5 kg/m2. We also compared the outcomes of SG-JJB to those of sleeve gastrectomy (SG). Methods: This retrospective study included 60 patients between September 2023 and October 2024 at shanghai ninth people’s Hospital, in shanghai, or lancing first people’s Hospital, Pu’er, China. Among them, 40 patients were underwent SG and 20 patients were received SG-JJB. SG-JJB consists of SG and performing a jejunoileal anastomosis 240 cm distal to the angle of Treitz. Postoperative total weight loss (TWL), T2DM remission and patient complication were compared. Resluts: All the operations were performed laparoscopically and the mean postoperative follow-up was 18 months (13-27). The mean age was 36 years (21–53), 85 % of patients were female and Mean preoperative BMI was 37.6 kg/m2 (33–50.2 kg/m2) in SG group, while it was 37 years (23–61), 83 % and 38.3 kg/m2 (34.5–48.8 kg/m2) in SG-JJB group (P>0.05). Patients in SG-JJB group had a longer operation time (135± 15 min vs 106± 10 min) and postoperative hospital stay (6 days vs 4 days) than patients in SG group (P<0.01). SG-JJB yielded higher TWL than SG alone (32.3±7.1% vs 28.9±9.1%, P<0.05). Complete T2DM remission was achieved in 85% of patients (17/20) and partial remission in 15% (3/20) in SG-JJB, while it was 70% (28/40) and 30% (12/40) in SG group. It suggests that SG-JJB has a greater advantage in T2DM. There were no deaths, no postoperative bleeding, no re-operation and no gastric fistula in all patients. The incidence of postoperative gastroesophageal reflux disease (GERD) symptoms is similar in SG-JJB (10%, 2/20) and SG (12.5% 5/40)(P>0.05). Conclusion: SG-JJB is a safe surgical technique for T2DM in patients with BMI ≥32.5 kg/m2, it yielded higher TWL and diabetes remission than SG.