Bariatric surgery, specifically sleeve gastrectomy, is one of the fastest-growing segments within the surgical discipline. As with all evolving medical fields, it can lead to unexpected complications. One such rare and significant complication is gastro-bronchial fistula, which typically results from anastomotic leakage. In most cases, antibiotic therapy is adequate to manage this condition. The clinical presentation is often insidious, with patients remaining clinically stable. Here, we present the case of a 29-year-old female who required thoracotomy to treat a pulmonary abscess. This abscess was caused by a chronic leak from the sleeve gastrectomy staple line, occurring five years post-surgery.