The prevalence of overweight and obesity increased significantly during the past decades, affecting now approximately 30% of people worldwide. Bariatric surgery has proven to be the most effective treatment modality for obesity in the long term. However, current surgical procedures are accompanied by a substantial risk of complications. Several endoluminal techniques have been developed to achieve weight loss in obese patients and claim to be as effective as surgery but safer. The aim of this review is to evaluate the efficacy and safety of endoscopic bariatric procedures that provide structural changes in anatomy and physiology of the gastrointestinal tract. A comprehensive search was conducted using online databases and the references of the selected articles. All studies included in this review show excess weight loss in the short-term to medium-term, which ranges from 24% to 58%. Seven serious adverse events were reported. Therefore, we conclude that endoscopic bariatric procedures providing structural changes show relatively low complication rates and promising short-term weight loss and effect on obesity-related comorbidities. Long-term results in large study populations are necessary before these techniques can be incorporated in the standard treatment of obesity.