Childhood obesity has become a national epidemic and children are diagnosed with co-morbidities once only associated with adults. Despite current interventions, children continue to exude poor diet and physical activity outcomes. The final project is an adolescent weight management algorithm to include bariatric surgery for select adolescents who meet the criteria. The algorithm developed was in congruence with a regional healthcare facility mission and goals. A literature review was conducted by searching databases EBSCO, CINAHL, Bing, Google Scholar and Academic Search Premier. The algorithm was developed by reviewing current literature and evidence on adolescent bariatric surgery. Experts in the field of adolescent bariatric surgery were contacted to evaluate the proposed algorithm. The development of an adolescent bariatric surgery program poses many challenges as it remains a relatively new process. The screening adolescents undergo before surgery is extensive and takes several months to complete. The algorithm may be helpful in the development of an adolescent bariatric surgery program and in the primary care setting as it can guide providers in the adolescent weight management process. The algorithm and the recommendations may be used as a starting point for program development and adolescent weight management, but the ultimate decision on which adolescents have surgery should be based on expert medical and surgical personnel judgment.