The aim of this review was to highlight the potential of glucagon-like peptide-1 receptor agonists (GLP-1RAs) in the treatment of type 2 diabetes with regard to metabolic and pleiotropic effects such as cardio- and nephroprotection. GLP-1 RAs exert their main action by stimulating glucose-dependent insulin release from beta cells and inhibiting glucagon secretion from alpha cells. They have also been shown to slow gastric emptying and reduce food intake. Ultimately, this leads to a reduction in HbA1c levels and body weight. These features make GLP-1 RAs a unique treatment option. In addition, GLP-1 RAs act on the heart and show outstanding cardioprotective properties, including an increase in glucose utilization, left ventricular function and myocyte survival. Cardiovascular outcome studies have confirmed that GLP-1 RAs reduce the risk of cardiovascular death, non-fatal myocardial infarction, and non-fatal stroke. The antiatherosclerotic effects of GLP-1 RAs are associated with the action of GLP-1 on blood vessels, leading to increases in vasodilation, blood flow, plaque stability, and endothelial function, as well as decreases in smooth muscle cell proliferation, blood pressure, and platelet aggregation. Furthermore, GLP-1 RAs have been shown to reduce the development of new-onset macroalbuminuria, urinary albumin excretion and to slow the decline in estimated glomerular filtration rate. Nevertheless, GLP-1 RAs also have some disadvantages, mostly associated with gastrointestinal symptoms such as nausea and vomiting. An increase in heart rate has also been noted in several studies. The future of incretin therapy is very promising, with triple agonists being developed that will provide even more effective glycemic control and body weight reduction in patients with type 2 diabetes.