This survey by the International Federation for the Surgery of Obesity and Metabolic Disorders (IFSO) aims to describe the current trends in metabolic and bariatric surgery (MBS) procedures performed worldwide and within each IFSO chapter from 2020 to 2021. The survey was conducted among 74 IFSO national societies, with 57 (77%) submitting responses. The total number of surgical and endoluminal procedures performed globally in 2020 was 507,806, and in 2021 it increased to 598,834. Sleeve gastrectomy (SG) remained the most common procedure, while adjustable gastric banding (AGB) continued to decline. Thirty national societies (52%) had regional protocols for MBS during the COVID-19 pandemic, and 61.4% supported the use of telemedicine. However, only 47.3% collected data on mortality after MBS in 2020, with no significant change in 2021. The survey also analyzed trends within different IFSO chapters, showing variations in the adoption of national protocols, use of telemedicine, and data collection on mortality. The results highlight the impact of the pandemic on MBS procedures and the evolving practices in various regions.This survey by the International Federation for the Surgery of Obesity and Metabolic Disorders (IFSO) aims to describe the current trends in metabolic and bariatric surgery (MBS) procedures performed worldwide and within each IFSO chapter from 2020 to 2021. The survey was conducted among 74 IFSO national societies, with 57 (77%) submitting responses. The total number of surgical and endoluminal procedures performed globally in 2020 was 507,806, and in 2021 it increased to 598,834. Sleeve gastrectomy (SG) remained the most common procedure, while adjustable gastric banding (AGB) continued to decline. Thirty national societies (52%) had regional protocols for MBS during the COVID-19 pandemic, and 61.4% supported the use of telemedicine. However, only 47.3% collected data on mortality after MBS in 2020, with no significant change in 2021. The survey also analyzed trends within different IFSO chapters, showing variations in the adoption of national protocols, use of telemedicine, and data collection on mortality. The results highlight the impact of the pandemic on MBS procedures and the evolving practices in various regions.