Objective: The current study aimed to explore the prevalence rate of hyperuricemia in women with polycystic ovary syndrome (PCOS) and investigate the relationship between Visceral adiposity index (VAI) and hyperuricemia in PCOS.Methods: In this cross-sectional study, 318 PCOS women were evaluated between November 2018 to September 2020. Of them, 256 subjects with complete anthropometric and the serum uric acid (SUA) level data were analyzed. Multivariable linear regression and logistic regression analyses were performed to determine the associations of VAI with the SUA level and hyperuricemia.Results: The prevalence rate of hyperuricemia was 56.3% in women with PCOS and was gradually increased across tertiles of VAI, which was 2.6%, 21.3%, 22.4%, respectively. Obese subjects had significantly higher levels of systolic blood pressure (SBP), waist circumference (WC), hip circumference (HC), waist-to-hip ratio (WHR), body fat percentage (BFP), triglycerides (TG), low-density lipoprotein cholesterol (LDL-c), VAI (P<0.001) and lower high-density lipoprotein cholesterol (HDL-c) (P<0.001). Pearson correlation analysis showed the SUA level was positively correlated with BMI, BFP, WHR, log (TG), log (LDL-c), SBP, and log (VAI) and negatively correlated with HDL-c. In addition, with adjustment for potential confounding factors, multivariable linear regression and logistic regression analyses showed that VAI significantly associated with the SUA level and hyperuricemia, with the coefficient (95% confidence interval (CI)) of 9.20 (2.85-15.56, P=0.005) and the adjusted odds ratio (95% CI) of 1.32 (1.05-1.65, P=0.018), respectively.Conclusion: The present study indicates that VAI was independently associated with hyperuricemia, even with adjustment for BMI and other potential confounding factors.