Abstract: Polycystic ovary syndrome (PCOS) is the most common endocrine disease in women of childbearing age, affecting women′s reproduction, metabolism and other aspect of patients. The placenta is a key medium that affects the outcome of pregnancy and childbirth and the development of the offspring. The abnormal placental structure and function caused by prenatal hyperandrogenism and abnormal glucose and lipid metabolism environment may be the main reason for the low birth weight, macrosomia, and even endocrine and metabolic system diseases after adulthood in the offspring of PCOS. This article reviewed the pathological effects of hyperandrogenin and insulin resistance on the placenta of PCOS, summarized the research results of PCOS related placental dysfunction, explored the causes of placental structure and function abnormalities in PCOS pregnancy and the corresponding placental pathological characteristics, so as to provide a reference for targeted treatment to prevent PCOS related pregnancy complications and PCOS related diseases in the offspring.