Post-Roux-en-Y (RY) gastric bypass abdominal pain can be due to a diversity of reasons. This complication is under-reported and sometimes hard to diagnose. We present a video case with possible causes and their management. Roux-en-Y gastric bypass (RYGB) is the gold standard in bariatric surgery. Post- operative weight loss, co-morbidity resolution and quality of life (QoL) factors following RYGB have been thoroughly reported. However, postoperative chronic abdominal pain is underresearched in the literature. A large study of 1429 patients showed that abdominal pain is the most common symptom (34%) for patients who contact their treating bariatric teams for assistance. Possible causes are cholelithiasis, anastomotic ulcers, internal hernia and candy cane syndrome.