PCOS is a prevalent endocrine condition affecting women in their reproductive years all over the world. Metabolic abnormalities in women with PCOS frequently include insulin resistance and dyslipidemia, which is characterized by low levels of HDL and increased cholesterol. Metformin, an insulin-sensitizing medication, is commonly used to treat PCOS. Omega-3 fatty acids, found in fish oil supplements, have been shown to have beneficial effects on lipid profiles and reduce inflammation, making them a potential complementary therapy for PCOS. This study aimed to evaluate the effect of a combination of metformin and omega-3 supplements on the lipid profiles of women with PCOS. This study aim to evaluate the effect of using metformin (1000mg/day) and omega 3(1000mg/day) for 3 consecutive months on cholesterol and HDL level (in prospective manner) of patient serum with PCOS. This study was performed at gynecology outpatient clinic and infertile center in AL-batol hospital during the period from December 2021 to march 2022. A total 59 women between (18-40years) with PCOS were randomly assigned into two group, the first group were taking metformin for 12 week and the second group were taking metformin and omega 3 for 12 week. There cholesterol and HDL were measure before and after the treatment .The result show that use of metformin and omega 3 is more significant (P value 0.281) in reducing the level of cholesterol and increase HDL(p value 0.627) than metformin alone (p value 0.525) and (p value 0.106) respectively.