Long-acting GLP-1 receptor agonists like semaglutide (Ozempic) can slow gastric emptying, increasing the risk of perioperative nausea, vomiting, and aspiration during anesthesia. Therefore, it is generally recommended to skip the dose of Ozempic in the week before surgery to minimize these risks. The medication can be resumed postoperatively when the patient is able to tolerate oral intake and once the surgical team determines it is safe. Coordination with the patient’s endocrinologist or primary care provider is recommended for optimal perioperative diabetes management.