Dumping syndrome is a recognized complication of bariatric surgery but has not been previously reported following endoscopic sleeve gastroplasty (ESG). We present a woman in her mid-30s who underwent ESG in 2022, achieving a body mass index reduction from 35.4 to 26.7 kg/m ² . Following subsequent laparoscopic cholecystectomy for cholelithiasis, she developed stereotyped postprandial episodes of diaphoresis, palpitations, lightheadedness, nausea, diarrhea, and bloating, with a Sigstad score of 12 confirming dumping syndrome. Dietary modification and acarbose provided meaningful relief. This case raises the possibility that ESG-related changes in gastric physiology may predispose to dumping syndrome, particularly after subsequent abdominal surgery.