Background: Gastroesophageal reflux disease (GERD) is a common gastrointestinal disorder that significantly impacts patients’ quality of life. Surgical intervention is often required when medical management fails, with laparoscopic Nissen and Toupet fundoplication being the two widely performed procedures. This study aims to compare the clinical outcomes, complications, and patient satisfaction associated with these two techniques. Materials and Methods: A prospective comparative study was conducted on 120 GERD patients undergoing laparoscopic fundoplication, with 60 patients receiving Nissen fundoplication and 60 undergoing Toupet fundoplication. Patients were assessed preoperatively and postoperatively at 1, 6, and 12 months for symptom relief, complication rates, and patient-reported satisfaction using a standardized questionnaire. Statistical analysis was performed using SPSS software, with significance set at p<0.05. Results: Both procedures resulted in significant symptom improvement, with a higher resolution rate in the Nissen group (90%) compared to the Toupet group (85%). However, postoperative dysphagia was more prevalent in the Nissen group (25%) compared to the Toupet group (10%). Gas-bloat syndrome was reported in 20% of Nissen patients and 8% of Toupet patients. Patient satisfaction scores were slightly higher in the Toupet group (4.5/5) compared to the Nissen group (4.2/5). The overall complication rate was 15% in the Nissen group and 10% in the Toupet group, with no significant differences in operative time or hospital stay between the groups. Conclusion: Both Nissen and Toupet fundoplication are effective surgical treatments for GERD, providing symptom relief and high patient satisfaction. While Nissen fundoplication has a higher success rate in controlling reflux, it is associated with increased postoperative dysphagia and gas-related complications. Toupet fundoplication, on the other hand, offers a lower incidence of dysphagia with comparable reflux control, making it a preferable option for patients at risk of motility disorders.