Background: If medical treatment of obesity fails and if surgical gastroplasty is not indicated, insertion of an intragastric balloon may represent an intermediate modality. Methods: Two patients are reported in whom a balloon was placed for weight reduction before elective surgery: 1) A 53-year-old woman with a BMI of 41.3 kg/m2 lost 18 kg in 6 months and then underwent surgical repair of a huge incisional hernia; 2) A 58- year-old woman with a BMI of 35.8 kg/m2 had total hip arthroplasty after losing 15.5 kg in 5 months. Results: The uneventful postoperative recovery in both patients was thought to be positively influenced by their preoperative weight loss. Conclusion: In morbidly obese patients, intragastric balloon placement may contribute to preoperative weight reduction before elective surgery.