Analysis of 45,636 outpatient eye surgeries revealed that patients using GLP-1 receptor agonists like semaglutide experienced 93% higher odds of postoperative nausea requiring antiemetic treatment compared to non-users. Despite theoretical concerns about delayed gastric emptying leading to aspiration events, no such complications occurred in either group, and oxygen desaturation rates remained similar. This large-scale evidence challenges the growing momentum toward blanket perioperative discontinuation of these increasingly prescribed medications. With over 15 million Americans now using GLP-1 drugs for diabetes and weight management, surgical protocols must balance theoretical risks against real-world outcomes. The findings suggest current institutional screening protocols effectively identify appropriate candidates for continued use during minor procedures. However, the doubled nausea risk represents a meaningful quality-of-life consideration that warrants informed discussion between patients and providers. This represents confirmatory evidence supporting nuanced perioperative management rather than reflexive drug cessation, though the ambulatory eye surgery setting may not extrapolate to higher-risk procedures or patients with multiple comorbidities.