Polycystic ovarian syndrome is one of the most common conditions affecting Australian women and the commonest endocrine condition affecting women of reproductive age. The prevalence in Australia is between 12 - 21% with the highest rates in the indigenous population. Recently several paradigms have been challenged and this presentation will focus on up to date management including the recommendations regarding the current use of Metformin and the role of laparoscopic surgery in Polycystic Ovarian Syndrome.