Objective: In this review article the evidence based data about the late complications of PCOS will be discussed. Lifestyle and exercise and management are the important points in control and prevention of the sequels. Materials and Methods: Medline and Cochrane review. Results: Polycystic ovary syndrome is associated with a variety of clinical disturbances including infertility menstrual dysfunction hyperandrogenism elevated risk of pregnancy complications and metabolic abnormalities such as increase in the prevalence of obesity insulin resistance and compensatory hyperinsulinemia endometrial cancer and cardiovascular diseases. The problem of overweight and obesity is extremely prevalent in the PCOS population and there is considerable evidence that obesity plays a negative role in the pathophysiology of PCOS. Lifestyle and genetics are the common predisposing factors in PCOS. The majority of studies support the positive effect of weight loss on improving risk factors for CVD and T2DM reproductive endocrine parameter and outcomes in PCOS. In this lecture the role of exercise and diet in treating the syndrome which though consistently recommended as the frontline therapy will be discussed. Lifestyle modification programs with an emphasis on behavioral management and dietary and exercise interventions have been successful in reducing the risk of diabetes and the metabolic syndrome in the general population and improving reproductive and metabolic features in PCOS. There is limited evidence for specific dietary and exercise approaches and guidelines for use in PCOS. These strategies can be implemented into longer-term weight maintenance regimens through use of lifestyle modification techniques that consist of a multifaceted approach of dietary exercise and behavioral therapies that aim to educate the individual with principles and techniques to achieve dietary and exercise. Alternatives to lifestyle management are anti-obesity pharmacology drugs such as metformin and bariatric surgery that they have limited and short time benefits for weight loss and lifestyle modification. Conclusion: the most important aim of PCOS management is control and prevention of late onset complications and lifestyle modification and secrecies have proved to be critical in the management of PCOS.