Background: Polycystic ovary syndrome (PCOS) is the most common endocrine disorder, affecting an estimated 5% to 18% of women of reproductive age and 3% to 11% of adolescents. The diagnostic criteria for PCOS in adults are not entirely suitable for adolescents, as certain features may represent normal physiological changes during puberty. Ongoing research aims to refine these diagnostic criteria for teenagers. PCOS is linked to hormonal and metabolic disturbances and increases the risk of associated conditions, including obesity, metabolic syndrome, hypertension, type 2 diabetes, and non-alcoholic fatty liver disease (NAFLD). This review was conducted following PRISMA guidelines, employing a systematic search of three major databases: PubMed, Google Scholar, and Embase. Given the high prevalence of PCOS and its potential health complications, it is crucial to identify at-risk adolescent girls early, ensure accurate diagnosis, initiate timely treatment, and promote lifestyle modifications. Current research increasingly focuses on adolescent patients with PCOS. This review aims to explore recent findings on the prevalence, pathophysiology, and diagnostic approaches for PCOS in adolescents.