Tirzepatide achieved meaningful metabolic improvements in solid organ transplant recipients, reducing HbA1c by 0.6-1.4 percentage points and body weight by 5.5-6.9 kg across six studies encompassing 182 patients. Critically, renal function remained stable with one study showing modest eGFR increases, while tacrolimus immunosuppressant levels fluctuated minimally, indicating no significant drug interactions. This represents a significant advancement for transplant medicine, where post-surgical metabolic management has historically been problematic. Immunosuppressive medications typically worsen diabetes and obesity, creating a therapeutic paradox where controlling these conditions is essential for graft survival yet challenging to achieve safely. Tirzepatide's dual GIP/GLP-1 mechanism appears uniquely suited for this population, offering robust glycemic control and weight reduction without compromising transplanted organ function. The stable renal parameters are particularly encouraging given concerns about incretin therapies in immunocompromised patients. However, these promising signals emerge from retrospective data with inherent limitations including small sample sizes and short follow-up periods. The finding is confirmatory of tirzepatide's broader metabolic benefits but extends them to a previously unstudied high-risk population, warranting larger prospective trials to establish definitive safety profiles.