Polycystic Ovary Syndrome (PCOS) is one of the most common endocrine disorders affecting women of reproductive age, characterized by chronic anovulation, hyperandrogenism, and polycystic ovarian morphology. Despite being recognized for nearly a century, the etiology and optimal management of PCOS remain subjects of intense research and debate. This syndrome not only disrupts reproductive health but also exerts significant metabolic, cardiovascular, and psychological consequences. This article explores the contemporary understanding of PCOS from the standpoint of pathogenesis and highlights the latest trends in treatment — including lifestyle modification, pharmacological interventions, surgical options, and emerging molecular therapies. The paper emphasizes the importance of personalized medicine in the management of PCOS, considering the heterogeneity of its clinical manifestations. A multidisciplinary approach integrating endocrinology, gynecology, and psychology offers the most effective strategy for restoring hormonal balance, ovulatory function, and improving overall quality of life in affected women.