The Endocrine Society has developed clinical practice guidelines for the diagnosis and treatment of polycystic ovary syndrome (PCOS). The guidelines, based on the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) system, aim to provide clear and consistent recommendations for healthcare providers. The diagnosis of PCOS is primarily based on the Rotterdam criteria, which include androgen excess, ovulatory dysfunction, and polycystic ovaries. The guidelines emphasize the importance of excluding other disorders that mimic PCOS, such as thyroid disease, hyperprolactinemia, and nonclassic congenital adrenal hyperplasia. For adolescents, the diagnosis of PCOS is more challenging due to the normal physiological changes during reproductive maturation. Hyperandrogenism and persistent oligomenorrhea are key factors in diagnosing PCOS in adolescents. In perimenopausal and menopausal women, a long-term history of oligomenorrhea and hyperandrogenism is used to make a presumptive diagnosis. The guidelines also address associated morbidity and evaluation, including cutaneous manifestations, infertility, pregnancy complications, and risk factors for endometrial cancer, depression, sleep-disordered breathing, nonalcoholic fatty liver disease (NAFLD), and type 2 diabetes mellitus (T2DM). They recommend screening for these conditions and provide specific recommendations for management. Treatment recommendations include the use of hormonal contraceptives for menstrual abnormalities and hirsutism/acne, clomiphene citrate for infertility, and metformin for metabolic and glycemic abnormalities. The guidelines also suggest lifestyle interventions, such as exercise and weight loss, for overweight/obese patients. Other treatments, such as insulin sensitizers and statins, are not recommended due to safety concerns or lack of evidence. The guidelines emphasize the importance of a comprehensive approach to managing PCOS, considering individual patient circumstances, values, and preferences. They also highlight the need for ongoing research to improve the understanding and treatment of PCOS.The Endocrine Society has developed clinical practice guidelines for the diagnosis and treatment of polycystic ovary syndrome (PCOS). The guidelines, based on the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) system, aim to provide clear and consistent recommendations for healthcare providers. The diagnosis of PCOS is primarily based on the Rotterdam criteria, which include androgen excess, ovulatory dysfunction, and polycystic ovaries. The guidelines emphasize the importance of excluding other disorders that mimic PCOS, such as thyroid disease, hyperprolactinemia, and nonclassic congenital adrenal hyperplasia. For adolescents, the diagnosis of PCOS is more challenging due to the normal physiological changes during reproductive maturation. Hyperandrogenism and persistent oligomenorrhea are key factors in diagnosing PCOS in adolescents. In perimenopausal and menopausal women, a long-term history of oligomenorrhea and hyperandrogenism is used to make a presumptive diagnosis. The guidelines also address associated morbidity and evaluation, including cutaneous manifestations, infertility, pregnancy complications, and risk factors for endometrial cancer, depression, sleep-disordered breathing, nonalcoholic fatty liver disease (NAFLD), and type 2 diabetes mellitus (T2DM). They recommend screening for these conditions and provide specific recommendations for management. Treatment recommendations include the use of hormonal contraceptives for menstrual abnormalities and hirsutism/acne, clomiphene citrate for infertility, and metformin for metabolic and glycemic abnormalities. The guidelines also suggest lifestyle interventions, such as exercise and weight loss, for overweight/obese patients. Other treatments, such as insulin sensitizers and statins, are not recommended due to safety concerns or lack of evidence. The guidelines emphasize the importance of a comprehensive approach to managing PCOS, considering individual patient circumstances, values, and preferences. They also highlight the need for ongoing research to improve the understanding and treatment of PCOS.