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Polycystic ovary syndrome (PCOS) is the commonest endocrine disorder of reproductive-age women and is associated with menstrual irregularity, hyperandrogenism, infertility and long-term metabolic risk. Indian studies report a high prevalence with distinct metabolic features. Ayurveda addresses gynaecological disorders under Strirogas, with detailed descriptions of Artava, Artava-vyapad, Asrigdara and Yonivyapat. PCOS is commonly correlated with Kapha-Meda and Vata obstruction of Artavavaha Srotas, sometimes termed Artava Kshaya or Granthi-like states. This article reviews the classical concepts, the modern diagnostic framework, Panchakarma procedures including Vamana, Virechana, Basti and Uttarabasti, lifestyle integration, and the limited evidence base. Lifestyle modification remains first-line in modern guidelines, and Panchakarma can be offered as a supervised adjunct after exclusion of other pathology.