Polycystic ovary syndrome (PCO) is a polygenic disease worsened by obesity and environmental factors. PCO is characterized by chronic menstrual irregularity and hypofertility and metabolic disorders. Routine care includes appropriate diet, exercise and annual check-up to search for high blood pressure. Laboratory tests should include a lipid profile and fasting serum glucose. Insulin sensitizing drugs improve the metabolic pattern, induce ovulation and increase pregnancy rate. Here, we review the different therapeutic options for these patients.