Analysis of 489,785 semaglutide-treated adults reveals the GLP-1 receptor agonist delivers substantial liver benefits through mechanisms distinct from weight loss. In patients with liver disease, median liver stiffness decreased from 4.85 to 3.9 kPa, with 40.8% achieving clinically meaningful 20% reductions. Remarkably, patients with cirrhosis-range baseline stiffness saw 80% improvement rates versus 29.5% in those with minimal disease. Higher semaglutide doses correlated with reduced long-term risks of steatohepatitis and liver-related mortality, while weight loss patterns showed different protective associations—suggesting dual pathways of liver protection. The liver benefits appeared durable even after reduced prescribing, indicating lasting effects beyond peak drug exposure. This finding challenges the assumption that semaglutide's liver benefits stem primarily from weight reduction, as stiffness improvements showed negligible correlation with weight, BMI, or standard liver enzyme changes. Single-cell RNA analysis revealed minimal hepatic GLP-1 receptor expression, pointing toward indirect protective mechanisms. As a preprint awaiting peer review, these results require validation, but suggest semaglutide may offer liver-specific therapeutic value independent of its well-established metabolic effects.