Polycystic ovary syndrome (PCOS) is a condition of unexplained hyperandrogenic chronic anovulation that most likely represents a heterogenous disorder. Its etiology remains unknown, and treatment is largely symptom based and empirical. Recent findings suggest PCOS has substantial metabolic sequelae, including risk of diabetes and possibly cardiovascular disease, and that primary treatment should focus on metabolic sequelae. The purpose of this document is to examine the best available evidence on the diagnosis and clinical management of PCOS.