Introduction: Polycystic ovary syndrome (PCOS) is a common endocrine and reproductive disorder among women of child-bearing age worldwide. Well known to possess clinical heterogeneity, the disorder manifests through a range of combinations hyperandrogenism, ovulatory dysfunction and polycystic ovarian morphology leading to both short- and long-term reproductive, metabolic and psychological aftermaths. This narrative review will shed light on up-to-date knowledge regarding the epidemiology, pathophysiology, diagnostic criteria, clinical features, complications and management of PCOS based on recent international guidelines as well as published systematic reviews and meta-analyses performed in a timeframe predominantly extending from 2019 to October 2023. We thus examined this condition in the context of variable reported prevalence, sociocultural, diagnostic and health-system factors that influence recognition and management, focusing upon regional data from Iraq and throughout the Middle East. Despite the substantial global consensus around use of the Rotterdam diagnostic criteria and 2023 International Evidence-Based Guideline for assessment and management, this review documents ongoing population-level epidemiological knowledge gaps-in particular from lower- and middle-income countries such as Iraq-and ends with local research priorities.