Context: Polycystic ovary syndrome (PCOS) is one of the most common heterogenous endocrinopathy in women affecting 5–10% of women in reproductive age group. Excess synthesis of ovarian androgens plays an essential role in the clinical and biochemical manifestations of hyperandrogenism in patients with PCOS. Cutaneous manifestations might be the first sign of PCOS. Hence, this study was intended to evaluate the correlation between cutaneous and biochemical markers of hyperandrogenism in PCOS patients. Aims: To determine the profile of cutaneous manifestations and to evaluate their correlation with biochemical hyperandrogenism in women with PCOS. Settings and Design: A cross‑sectional clinical study was carried out at a tertiary care hospital over a period of 18 months from May 2024 to December 2025 Methods and Material: Seventy-one consecutively diagnosed cases of PCOS were enrolled. Cutaneous manifestations were ascertained, hirsutism was assessed using the modified Ferriman–Gallwey score, severity of acne was assessed, and androgenic alopecia (AGA) was assessed using the Ludwig’s scale. Biochemical hyperandrogenism was determined from serum concentration of total testosterone (TT), free testosterone (FT) and dehydroepiandrosterone sulfate (DHEAS). Fasting serum insulin levels and ultrasonological assessment was done in all the cases. Statistical analysis used: Associations between clinical hyperandrogenism and serum androgen levels were analyzed using Spearman’s rank correlation. The strength of association was measured by correlation co-efficient (r). A two-tailed P-value of <0.05 was considered statistically significant. Results: The prevalence of hirsutism, acne, AGA, acanthosis nigricans, seborrhea, and acrochordons was 67%, 65%, 51%, 43%, 24%, and 10% respectively. Levels of TT, FT, and DHEAS were raised in 66%, 51%, and 31% of patients respectively. There was a statistically significant correlation in the following pairs: hirsutism and FT (P< 0.05); hirsutism and DHEAS (P< 0.05); acne and FT (P< 0.05); acne and TT (P<0.05); and AN and insulin (P< 0.05). Conclusions: Hirsutism and acne are good predictors for biochemical hyperandrogenism in women with PCOS in our study population. Early correction of biochemical hyperandrogenism will help to ameliorate the cutaneous markers and improve the quality of life of these patients.