Background Polycystic ovary syndrome (PCOS) is a prevalent endocrine disorder associated with reproductive and metabolic dysfunction, particularly in overweight or obese women. Objective To evaluate the efficacy and safety of Liraglutide, a glucagon-like peptide-1 receptor agonist (GLP-1 RA), on metabolic and reproductive outcomes in overweight or obese women with PCOS. Search Strategy Five electronic databases and one trial registry were systematically searched from inception to May 2025. Selection Criteria Randomised controlled trials comparing Liraglutide (alone or in combination) with placebo, metformin, or other active treatments in overweight or obese women with PCOS. Data Collection and Analysis Two reviewers independently performed study selection, data extraction, and risk of bias assessment. Data were pooled using a random-effects model. Effect sizes were reported as Hedges’ g or odds ratios with 95% confidence intervals (CIs). PRISMA guidelines were followed. Main Results Seven RCTs involving 330 women were included. Liraglutide significantly improved menstrual frequency (g = 1.76, 95% CI 0.28-3.24), reduced BMI (g = -0.52, 95% CI -0.94 to -0.10), and decreased insulin resistance (HOMA-IR; g = -0.52, 95% CI -0.83 to -0.22). A non-significant reduction in free androgen index was observed. Trends toward improved ovulation and pregnancy rates were noted but not pooled due to heterogeneity. Secondary analyses showed favourable changes in hormonal and metabolic parameters. Gastrointestinal side effects were the most common adverse events, typically mild. Conclusions Liraglutide improves metabolic outcomes and menstrual regularity in overweight or obese women with PCOS. Reproductive benefits are promising but require confirmation in larger, long-term studies.