OBJECTIVE: To evaluate the clinical, hormonal and metabolic characteristics according to luteinizing hormone (LH)/follicle stimulating hormone (FSH) ratio in women with polycystic ovary syndrome (PCOS). METHODS: A total of 225 women with PCOS were included in this study. They were divided into two groups according to LH/FSH ratio; group A (LH/FSH < 2, n=160) and group B (LH/FSH > 2, n=65). We compared clinical, hormonal and metabolic characteristics including age at menarche, body mass index (BMI), blood pressures, ovarian volume, and serum androgen levels between the two groups. Serum glucose and insulin levels, fasting glucose/insulin ratio, homeostatic model assessment of insulin resistance (HOMA-IR), and lipid profiles were also compared between the two groups. Pearson correlation coefficients were used to evaluate correlation between the LH/FSH ratio and various parameters. RESULTS: Age of menarche in the group B was significantly later than that in the group A. BMI, waist-hip ratio and blood pressures were significantly lower in the group B compared to those of the group A. Ovarian volume and serum levels of LH, estradiol, total testosterone, sex-hormone binding globulin, 17-hydroxyprogesterone (OHP), and high density lipoprotein were significantly higher in the group B. Postprandial 2 hours glucose, insulin and HOMA-IR were significantly higher in the group A. After adjustment of BMI, the LH/FSH ratio was significantly positively correlated with age at menarche, ovarian volume, total testosterone levels, and 17-OHP levels. CONCLUSION: The inappropriate gonadotropin secretion may be negatively correlated with BMI, and positively with age of menarche and increased ovarian androgen production irrespective of BMI in women with PCOS. However, it may not be associated with metabolic characteristics