Objective—To evaluate UAE in normotensive and non-diabetic women with PCOS in relation to their clinical, endocrine and metabolic profiles. Polycystic ovary syndrome (PCOS) is associated with increased cardiovascular risks including evidence of altered endothelial function. Urinary albumin excretion (UAE) is closely related to endothelial function and closely correlates with nephropathy and adverse cardiovascular endpoints. Design—Observational study. Setting—University fertility center. Patient(s)—Sixty-three women with PCOS were evaluated. Intervention(s)—Clinical assessments and urine and blood testing. Main Outcome Measure(s)—UAE, systolic and diastolic blood pressure, serum levels of LH, FSH, prolactin, testosterone, 17-hydroxyprogesterone, glucose, insulin, lipids, C-reactive protein and 24-hour urinary free cortisol. Result(s)—In univariate and multivariate correlation analysis, UAE correlated with diastolic blood pressure, insulin area under the curve during glucose tolerance test, prolactin and 17- hydroxyprogesterone. Overt microalbuminuria was detected in a significant proportion of subjects. Conclusion(s)—Urinary albumin excretion in women with PCOS correlates well with other cardiovascular risk factors. Since the relationship between UAE and adverse cardiovascular events is continuous, evaluation of UAE in the presence of PCOS may provide clinically relevant information and may aid in selecting appropriate patients for more aggressive treatment of likely aggravating factors, such as hyperinsulinemia or borderline hypertension