Weight loss surgery (WLS) is an effective group of procedures with a low rate of complications, preventing or treating several cardiovascular co morbidities associated with morbid obesity.Pain management in the preoperative needs special consideration in this population because of different aspects, specially the theoretical need for opioid avoidance, generally used in the postoperative of major surgeries.This literature review assesses the available information on analgesic strategies for WLS, with a special approach on multimodal settings and possible alternatives.Well-controlled studies are needed to determine the level of recommendation for individual therapies and multimodal regimens.