Background Hirsutism is a common clinical condition encountered in day‐to‐day practice. The androgenic causes account for more than 80% of these patients and include polycystic ovary syndrome (PCOS), which affects about 70%‐80% of hirsute women. The second most common cause is idiopathic hirsutism. Omentin‐1 is an adipokine mainly produced by visceral adipose tissue. Aim The current study aimed at evaluating omentin‐1 levels in hirsute females with PCOS and in idiopathic hirsutism. Patients and Methods Eighty‐five females were included in this study. They were classified into three groups: thirty hirsute patients with PCOS, thirty females with idiopathic hirsutism, and twenty‐five healthy control females. The participants were subjected to history taking, physical and dermatological examination. A gynecological history and radiological examination of the ovary also were done. Serum testosterone and omentin‐1 were measured by ELISA. Results Serum testosterone was statistically elevated in PCOS than other groups. Serum omentin‐1 in females with idiopathic hirsutism was statistically significantly higher than control and PCOS. There was a significant inverse correlation between serum testosterone level and serum omentin‐1 level. Conclusion Omentin‐1 may be involved in the pathogenic process of hirsutism.