Glucagon-like peptide-1 receptor agonists (GLP-1 RAs) confer multiple cardiometabolic benefits beyond glycemic control, including weight reduction and potential cardiovascular protection. This case presents an 18-month follow-up of a 48-year-old obese male with type 2 diabetes mellitus (T2DM) and hypertension, who achieved sustained blood pressure (BP) control and lipid stability on semaglutide following discontinuation of triple antihypertensive therapy. At baseline, the patient had a BMI of 38 kg/m², BP of 156/96 mmHg, and an elevated glycosylated hemoglobin (HbA1c). Semaglutide was initiated at 0.25 mg weekly and titrated to 1 mg over six months. The patient exhibited progressive improvements in glycemic control, body weight, and BP, with HbA1c reduction and weight loss sustained over 18 months. Notably, BP remained consistently ≤130/80 mmHg, and lipid parameters remained stable without additional pharmacotherapy. This case underscores the potential of GLP-1 RAs to exert antihypertensive effects, possibly through weight loss, vascular endothelial function enhancement, and modulation of the renin-angiotensin-aldosterone system (RAAS). These findings support the evolving role of GLP-1 RAs as a multifaceted therapeutic option in managing T2DM with coexisting cardiovascular risk factors.