OBJECTIVES:  Laparoscopic roux-en-Y gastric bypass (RYGB) and laparoscopic sleeve gastrectomy (SG) are currently the two most commonly-performed bariatric surgeries. This study used a real-world dataset to examine factors that are associated with the choice between these two procedures. METHODS:  The study was conducted using the Premier Perspective® Database, which contains a nationally representative sample of discharges from over 600 hospitals in the U.S. Included patients were >18 years of age and underwent laparoscopic RYGB or SG between January 2014-September 2015. A multivariable logistic regression model, in which the outcome was receipt of RYGB vs. SG (reference), was built with a broad range of predictor variables: patients’ demographics, body mass index (BMI), and provider/hospital information. RESULTS:  A total of 11,948 patients underwent RYGB, and 22,670 underwent SG. Compared to SG patients, RYGB patients had higher proportion in the BMI>50 category (29.3% vs 24.8%), but lower proportions in the BMI=35-39.9 (16.5% vs 19.2%) and BMI=40-50 (54.2% vs 56.0%) categories. In the logistic regression model, patients with BMI=40-50 and BMI>50 were more likely to have undergone RYGB, with ORs of 1.190 (95% confidence interval: 1.090-1.298, p<0.0001) and 1.417 (1.231-1.632, p<0.0001), respectively, treating patients with BMI=35-39.9 as the reference group. Other factors associated with an increased odds of undergoing RYGB included female (OR=1.188, p<0.0001) vs. male as reference group, comorbid conditions including diabetes (OR=1.587, p<0.0001), hypertension (OR=1.133, p=0.0022), and depression (OR=1.159, p=0.0175). Factors associated with a decreased odds of undergoing RYGB were older age (age 65-74 [OR=0.741, p=0.0283], age 75 and above [OR=0.426, p=0.0366] vs. age <45 as the reference group), and comorbid conditions including valvular disease (OR=0.779, p=0.0366), and rheumatoid arthritis (OR=0.708, p=0.0175). CONCLUSIONS: This study suggests that BMI level, age, gender, and the presence of selected comorbidities are important factors in whether patients undergo RYGB or SG.