Polycystic ovary syndrome (PCOS) is a common reproductive endocrine disorder. The metabolic aspect of disorder is characterized by obesity-related risk factors for cardiovascular disease. The aim of this study was to determine in women with PCOS, indices of lipid metabolism and their oxidation, and to assess possible relation to insulin resistance. We investigated 75 women with PCOS (age: 23.1±5.1 years, body mass index (BMI): 24.9±4.7 kg/m2) and 56 age and BMI respective controls. In all subjects after an overnight fast, blood samples were collected in follicular phase of the cycle for basal glucose, total-, HDL- and LDL-cholesterol, oxidized LDL (OxLDL), triglycerides, apolipoprotein A1, B and E, nonesterified fatty acid (NEFA), insulin, testosterone and SHBG. Homeostatic model (HOMA index) and free androgen index were determined. PCOS patients in comparison to controls had increased indices of insulin resistance, basal insulin and HOMA index (14.3±8.7 vs 8.2±3.4 mU/l, P<0.001 and 3.2±2.0 vs 1.7±0.7, P<0.001 respectively), and deteriorated insulin resistance-related dyslipidemia with decreased HDL-cholesterol (1.2±0.3 vs 1.5±0.3 mmol/l, P<0.01), elevated triglycerides (1.0±0.6 vs 0.8±0.4 mmol/l, P=0.010), and pronounced LDL oxidation 66.9±33.0 vs 50.2±14.6 ng/ml, P<0.001). In conclusion, PCOS women had characteristic dyslipidemia of insulin resistance. Elevated OxLDL, and relation to the insulin insulin (r=0.389, P<0.01) and HOMA (r=0.343, P<0.01), is suggestive on premature atherosclerosis in patients with PCOS.