Polycystic ovarian syndrome (PCOS) is a complex and phenotypically heterogeneous endocrine disorder that typically presents in reproductive-aged women. Key clinical components include hyperandrogenism, menstrual irregularities, infertility, and cardiometabolic abnormalities. Definition of PCOS has been confusing and controversial because of the lack of consistent diagnostic criteria. Management choices in women with PCOS should target the phenotype and individual needs of the patient. Oral contraceptives remain the first line of treatment for hyperandrogenic symptoms and menstrual dysfunction. Lifestyle modifications and metformin improve metabolic abnormalities. Particular attention should be placed on addressing and preventing the long-term cardiometabolic implications of PCOS.