BACKGROUND: Each year, increasing numbers of Americans travel abroad to undergo bariatric surgery. When postoperative complications arise, these patients often present to domestic emergency departments for care. CASE REPORTS: We present three patients who experienced severe postoperative complications after bariatric surgery in Mexico and subsequently sought emergency medical care at an under-resourced, rural community hospital in Southern California, just north of the US-Mexico border. SIGNIFICANCE: The presentation of patients with complications from bariatric surgery abroad at emergency departments, particularly those located near ports of entry, is likely to become more frequent. Emergency physicians should familiarize themselves with the clinical and operational challenges they may face when caring for this population.