A recent questionnaire aiming to understand which is the practice on diagnosis and management of polycystic ovary syndrome (PCOS) has been sent to all members of ESE. More than 13% of members of ESE participated in the survey. The main results were the following: i) the NIH criteria are followed by the majority of respondents; ii) obesity and type 2 diabetes were regarded as the principal long-term concerns, whereas much less concern was given to infertility; iii) the most common treatment for patients with PCOS were metformin, lifestyle modification, and oral contraceptives; iv) more direct treatments of infertility were used by <20% of the respondents. It clearly appears that endocrinologists have some different clinical perspectives when compared with gynaecologists, particularly in the treatment of choice. Treatment of PCOS by both endocrinologists and gynecologists largely depends on what they know about the pathophysiology of PCOS and on the main complains of each patient. Targeting treatment on patients need, including a clear balance among costs, benefits, and side effects, and based on the dominant phenotype, appears to be the best strategy.