The overlap between normal pubertal development and characteristic features of PCOS may confound an accurate diagnosis of PCOS among adolescent girls. Other disorders associated with irregular menses or hyperandrogenism need to be excluded from diagnostic consideration. Even in the absence of a definitive diagnosis and the lack of an approved therapy for PCOS in adolescence, treatment options that both alleviate the current symptoms and decrease the risk for subsequent associated comorbidities are recommended. Although obesity, insulin resistance, and hyperinsulinemia are common findings in adolescents with hyperandrogenism, these features should not be used to diagnose PCOS among adolescent girls.