The cascade stomach consists of a biloculation of the gastric cavity into a ventral (corpus and antrum) and a dorsal (fundus) recess and is a rare cause of upper abdominal symptoms. The causes of gastric cascade described in the literature are manifold and are separated into congenital, functional, or organic disorders. Patients with a gastric cascade can have a range of upper abdominal symptoms, including nausea, vomiting, dyspepsia, eructation, heartburn, epigastric pain, and early satiety. This disorder is often difficult to diagnose or is not recognized and, therefore, its true incidence is currently not known. As a consequence, data on the treatment of the condition are limited. Suggested treatment options in the literature range from conservative measures, such as bending exercises or dietary adjustments, to operative corrections, such as gastropexy and laparoscopic gastro-gastric anastomosis. In this paper, we summarize the literature findings on gastric cascade and report on a new treatment option: the laparoscopic gastric sleeve resection.