Polycystic ovarian syndrome (PCOS) is a common endocrine disorder affecting 10% of females, characterized by irregular menstrual cycles, hyperandrogenism, and polycystic ovarian morphology. It is associated with long-term health risks such as hypertension, type 2 diabetes, metabolic syndrome, cardiovascular disease, and mental health issues. Diagnosis is based on the Rotterdam criteria, which require two out of three: irregular cycles, clinical or biochemical hyperandrogenism, or polycystic ovarian morphology. Management includes lifestyle changes, such as weight loss, and medical treatments like combined hormonal contraceptives, metformin, and anti-androgens. Patients with PCOS require regular monitoring of BMI, blood pressure, and metabolic parameters, as well as screening for depression, anxiety, and obstructive sleep apnea. Early diagnosis and management can improve symptoms and reduce long-term complications. PCOS is a diagnosis of exclusion, requiring thorough evaluation to rule out other conditions. The pathophysiology involves hyperandrogenism and hyperinsulinemia, with complex interactions between these factors. Treatment options are tailored to individual needs, with a focus on improving reproductive outcomes, metabolic health, and overall quality of life. Patients with PCOS should be counseled about the nature of polycystic ovarian morphology and the importance of regular follow-up care.Polycystic ovarian syndrome (PCOS) is a common endocrine disorder affecting 10% of females, characterized by irregular menstrual cycles, hyperandrogenism, and polycystic ovarian morphology. It is associated with long-term health risks such as hypertension, type 2 diabetes, metabolic syndrome, cardiovascular disease, and mental health issues. Diagnosis is based on the Rotterdam criteria, which require two out of three: irregular cycles, clinical or biochemical hyperandrogenism, or polycystic ovarian morphology. Management includes lifestyle changes, such as weight loss, and medical treatments like combined hormonal contraceptives, metformin, and anti-androgens. Patients with PCOS require regular monitoring of BMI, blood pressure, and metabolic parameters, as well as screening for depression, anxiety, and obstructive sleep apnea. Early diagnosis and management can improve symptoms and reduce long-term complications. PCOS is a diagnosis of exclusion, requiring thorough evaluation to rule out other conditions. The pathophysiology involves hyperandrogenism and hyperinsulinemia, with complex interactions between these factors. Treatment options are tailored to individual needs, with a focus on improving reproductive outcomes, metabolic health, and overall quality of life. Patients with PCOS should be counseled about the nature of polycystic ovarian morphology and the importance of regular follow-up care.