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OBJECTIVES: To assess the safety of Sodium-Glucose Cotransporter 2 Inhibitors (SGLT2-I) during the fasting month of Ramadan, in a real-life scenario, by finding the frequency and severity of severe hypoglycemia, hyperglycemia, dehydration, or diabetic ketoacidosis (DKA). RESULTS: Total of 101 participants were enrolled and because of pandemic, we were able to collect complete data on 84 (83.2%) participants. Majority (n=44; 52.4%) of participants were males. Mean age of patients was 52.4±9.5 years with an average duration of T2DM was 11.5±6.5 years. Most of the study participants (n=54; 64.3%) were on Empagliflozin (mean-dose=14.7±7.1 mg/day) and 30 (35.7%) participants were on Dapagliflozin (mean-dose=8.2±2.7 mg/day). Only six patients (7.1%) reported having mild hypoglycemia. No study participant had any severe hypoglycemia, hyperglycemia, dehydration or DKA that would have required hospital admission. Changes observed were in the HbA1c (7.6±1.2% from 7.9±2.4%, p=0.34), weight (78.1±13.1 Kgs from 78.7±13.4 Kgs, p=0.23) and in creatinine (0.9±0.2 mg/dl from 0.9±0.4 mg/dl, p<0.09) within six weeks post Ramadan. CONCLUSION: SGLT2-I agents are safe and effective during the month of Ramadan in Pakistani patients with T2DM, without any additional adverse events.