Gastropleural fistula (GPF) is a pathological communication between the stomach and the pleura which might develop secondary to infections, malignancy, and repair of congenital defects. Recently, it has been reported secondary to sleeve gastrectomy (SG) in the adult population. Here we describe the first case of pediatric GPF secondary to SG that was complicated by hydropneumothorax and lung abscess. It was managed endoscopically with an over the scope clip (OVESCO) after failure of surgical repair.