A cohort-matched analysis reports that GLP-1 receptor agonist therapy is associated with lower long-term mortality and adverse limb outcomes in patients with peripheral artery disease (PAD) and type 2 diabetes. At five years, the treated group showed lower mortality (10.31% vs 14.49%, HR 0.74), reduced hospitalization, and fewer major and minor amputations. The results also showed reductions in revascularization (HR 0.64) and major amputation (HR 0.52), while rates of major adverse cardiovascular events and myocardial infarction/stroke were broadly similar between groups. The findings were positioned to support prioritizing GLP-1 RAs for limb- and cardiovascular outcomes in this high-risk population. Clinically, the analysis broadens the conversation beyond glycemic control toward cardiovascular and limb-safety outcomes, informing treatment selection for PAD patients with diabetes who are at elevated risk of hospitalization and amputation.