Obstructive sleep apnea syndrome (OSAS) is closely associated with obesity and metabolic dysfunction. Tirzepatide, a dual GLP-1 and GIP receptor agonist, has demonstrated superior efficacy for weight reduction and improved metabolic health compared with single GLP-1 agonists. Emerging evidence indicates that tirzepatide may alleviate OSAS through its multifaceted effects on adiposity, inflammation, and neuromuscular regulation. This review synthesizes the pharmacological mechanisms, clinical findings, and safety data of tirzepatide in OSAS management. Preliminary studies show promising reductions in body weight, apnea-hypopnea index (AHI), and systemic inflammation, although long-term trials remain warranted. Further exploration into its integration with existing OSAS therapies could redefine the pharmacologic management of obesity-related OSAS.