The benefit was driven by reductions in PE (HR, 0.88; 95% CI, 0.79-0.98; <i>p</i> = 0.021) and all-cause mortality (HR, 0.90; 95% CI, 0.82-0.99; <i>p</i> = 0.024), whereas no significant difference was observed for DVT (HR, 0.96; 95% CI, 0.86-1.07; <i>p</i> = 0.410).<h4>Conclusion</h4>In this large real-world cohort, tirzepatide use was associated with a significantly lower 1-year incidence of VTE compared with GLP-1 RAs in patients with obesity, particularly through reductions in PE and all-cause mortality. This evidence concerns the gene GLP1R and obesity due to melanocortin 4 receptor deficiency.