We attempt to synthesize main data in what concerns pathogenesis, signs and symptoms, diagnosis and management of polycystic ovary syndrome PCOS. The issue was the systematization of main data regarding different features of PCOS and stressing its peculiar association with characteristics of metabolic syndrome, main diagnostic criteria and most important therapeutic options, finally contouring an updated general picture of PCOS. We pointed also on associated morbidities, such as endometrial cancer, insulin resistance and need for individualized therapy, including changing in lifestyle, especially weight loss.