Objective: To investigate the effects of Jianpi Huatan recipe on lipid metabolism and expression of FOXO1 and PDK4 in rats with polycystic ovary syndrome (PCOS) and insulin resistance (IR) . Methods: Fifty female rats were randomly divided into a blank control group of 10 and a model group of 40. A PCOS-IR rat model was established using a high-fat diet (8 weeks) combined with letrozole (added at weeks 4-8), and the model was evaluated through HOMA-IR and ovarian tissue pathology observation. Thirty successfully modeled rats were randomly divided into a model control group, a Jianpi Huatan Fang group (11.07g/kg), and a Metformin group (0.2g/kg), with 10 rats in each group. Drug intervention was given for 4 weeks. Hematoxylin eosin (HE) staining was used to observe the histopathology changes of the ovary; Fasting blood glucose (FBG) and blood lipids (triglyceride TG, cholesterol (TC), high-density lipoprotein (HDL-C), low-density lipoprotein (LDL-C) were measured by blood biochemical analyzer; Enzyme linked immunosorbent assay (ELISA) was used to measure the levels of sex hormones follicle stimulating hormone (FSH), luteinizing hormone (LH), testosterone (T) and insulin (FINS); Immunoblotting (WB) and real-time fluorescence quantitative PCR were used to detect changes in the expression of FOXO1 and PDK4 in the ovaries. Results: Compared with the blank control group, the model control group showed significant weight gain, significant polycystic ovarian changes, and dysregulation of glucose and lipid metabolism (P<0.01). Compared with the model control group, the weight growth rate of rats in the Jianpi Huatan Fang group slowed down, and the development of follicles improved. Serum LH, T, LH/FSH, FBG, FINS, HOMA-IR, TC, TG, LDL-C decreased, E2 and FSH increased, while ovarian FOXO1, PDK4 mRNA and protein expression were down regulated (P<0.05, P<0.01); It can increase the serum HDL-C content, but there is no statistically significant difference between groups (P>0.05). Conclusion:Jianpi Huatan recipe can effectively regulate the secretion of sex hormones, improve the ovarian reproductive function and regulate glucose and lipid metabolism in obese PCOS-IR rats, which may play a role by inhibiting FOXO1/PDK4 pathway.