Fractalkine (CX3CL1) is a unique chemokine involved in leukocyte adhesion, migration, and obesity-associated adipose tissue inflammation. Although bariatric surgery results in substantial weight loss and metabolic improvement, the temporal pattern of circulating CX3CL1 levels following laparoscopic sleeve gastrectomy (LSG) remains poorly understood. This study aimed to evaluate longitudinal changes in serum CX3CL1 levels after LSG and to investigate their association with postoperative weight loss.