Women with polycystic ovary syndrome (PCOS) most often seek treatment for reduction of hair growth and/or acne, restoration of menstrual cyclicity, and infertility. In addition, these patients are increasingly seeking advise and treatment for the metabolic abnormalities related to PCOS (e.g., insulin resistance and type 2 diabetes). In this review, we outline the pathophysiologic events underlying the cutaneous manifestations of androgen excess and provide a rationale for use of the various pharmacologic agents available for treatment. Options for the treatment of the reproductive abnormalities (menstrual dysfunction and interfility) are presented. Finally, the metabolic manifestations of PCOS are reviewed and their treatment is discussed.