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