In this study, we used a large electronic health record (EHR) database encompassing over 1.2 million T2DM patients in the U.S. to conduct a multicenter retrospective cohort study to assess the association of GLP-1RAs with the risk of intestinal obstruction compared with non-GLP-1RA anti-diabetic medications including SGLT2 inhibitors, metformin, sulfonylureas (SU), thiazolidinediones (TZDs), dipeptidyl peptidase-4 (DPP-4) inhibitors, and insulins, across follow-up periods of 1, 3, and 5 years. This evidence concerns the gene DPP4 and intestinal obstruction.