Objective: Total knee arthroplasty (TKA) is one of the most common elective orthopaedic surgeries. In addition, there are rising rates of obesity and diabetes and, with it, medications to treat them. This retrospective cross-sectional analysis aims to examine the outcomes of patients who underwent TKA and were on a Glucagon-like peptide-1 agonist (GLP-1a) at the time of surgery Methods: This study analyzes a database using CPT and ICD-10 codes to identify patients having primary TKA for knee osteoarthritis. Patients were divided into two groups based on GLP-1a use at TKA. Control variables included sex, age, BMI, smoking status, ECI, and type 2 diabetes. Primary outcomes included surgical site infection (SSI) within 90 and 365 days, medical complications within 30 days, 90-day readmissions, implant complications, revision TKA, in-hospital mortality or discharge to hospice within 365 days, and initial hospital stay length. A sub-analysis focused on diabetic and non-diabetic populations and compared those taking semaglutide, dulaglutide, or liraglutide with non-GLP-1a users. Results: Results: 26,157 patients met inclusion criteria; 914 were on GLP-1a (668 diabetic, 246 non-diabetic). GLP-1a users were younger and had a higher BMI in both groups (p