Polycystic ovarian syndrome (PCOS) is a prevalent reproductive endocrine metabolic disorder within obstetrics and gynecology. Two pivotal features of PCOS, insulin resistance(IR) and hyperandrogenemia(HA), are both instrumental in its pathogenesis. There exists a discernible correlation between PCOS and mitochondrial oxidative stress, a relationship heavily influenced by various factors, most notably IR and HA. This article endeavors to elucidate the interplay between IR, HA, and mitochondrial oxidative stress while also exploring the impacts of insulin resistance and hyperandrogenemia on mitochondrial oxidative stress among PCOS patients.