Polycystic ovary syndrome (PCOS) is a common endocrine disorder characterized by irregular menses, hyperandrogenism, and polycystic ovaries. Its prevalence varies depending on diagnostic criteria, ranging up to 15%–20% using the European Society for Human Reproduction and Embryology/American Society for Reproductive Medicine (ESHRE/ASRM) criteria. Clinical features include oligomenorrhea, amenorrhea, hirsutism, and infertility. Risk factors include type 1 and 2 diabetes, gestational diabetes, and obesity. Insulin resistance affects 50%–70% of women with PCOS, leading to comorbidities such as metabolic syndrome, hypertension, dyslipidemia, glucose intolerance, and diabetes. Women with PCOS have increased coronary artery calcium scores and carotid intima-media thickness, and are at higher risk for mental health disorders like depression, anxiety, bipolar disorder, and binge eating disorder. Weight loss improves menstrual irregularities, androgen excess symptoms, and infertility. Management includes oral contraceptives for menstrual irregularities and hirsutism, spironolactone and finasteride for androgen excess, and clomiphene, laparoscopic ovarian drilling, gonadotropins, and assisted reproductive technology for infertility. Recent data suggest letrozole and metformin may play a role in ovulation induction. Proper diagnosis and management are essential to address patient concerns and prevent future metabolic, endocrine, psychiatric, and cardiovascular complications. Diagnosis requires the presence of hyperandrogenism or polycystic ovaries, with criteria varying among groups. Management strategies depend on symptoms, with treatment options including hormonal contraceptives, antiandrogens, metformin, and lifestyle changes. Infertility treatment options include clomiphene, letrozole, gonadotropins, and assisted reproductive technology. PCOS is associated with increased risks of hypertension, dyslipidemia, and cardiovascular events. Mental health disorders are also more prevalent in women with PCOS. Overall, PCOS requires individualized treatment focusing on metabolic and cardiovascular risks, with ongoing research needed to improve understanding and management.Polycystic ovary syndrome (PCOS) is a common endocrine disorder characterized by irregular menses, hyperandrogenism, and polycystic ovaries. Its prevalence varies depending on diagnostic criteria, ranging up to 15%–20% using the European Society for Human Reproduction and Embryology/American Society for Reproductive Medicine (ESHRE/ASRM) criteria. Clinical features include oligomenorrhea, amenorrhea, hirsutism, and infertility. Risk factors include type 1 and 2 diabetes, gestational diabetes, and obesity. Insulin resistance affects 50%–70% of women with PCOS, leading to comorbidities such as metabolic syndrome, hypertension, dyslipidemia, glucose intolerance, and diabetes. Women with PCOS have increased coronary artery calcium scores and carotid intima-media thickness, and are at higher risk for mental health disorders like depression, anxiety, bipolar disorder, and binge eating disorder. Weight loss improves menstrual irregularities, androgen excess symptoms, and infertility. Management includes oral contraceptives for menstrual irregularities and hirsutism, spironolactone and finasteride for androgen excess, and clomiphene, laparoscopic ovarian drilling, gonadotropins, and assisted reproductive technology for infertility. Recent data suggest letrozole and metformin may play a role in ovulation induction. Proper diagnosis and management are essential to address patient concerns and prevent future metabolic, endocrine, psychiatric, and cardiovascular complications. Diagnosis requires the presence of hyperandrogenism or polycystic ovaries, with criteria varying among groups. Management strategies depend on symptoms, with treatment options including hormonal contraceptives, antiandrogens, metformin, and lifestyle changes. Infertility treatment options include clomiphene, letrozole, gonadotropins, and assisted reproductive technology. PCOS is associated with increased risks of hypertension, dyslipidemia, and cardiovascular events. Mental health disorders are also more prevalent in women with PCOS. Overall, PCOS requires individualized treatment focusing on metabolic and cardiovascular risks, with ongoing research needed to improve understanding and management.