Background: Polycystic ovary syndrome (PCOS) is a disease with chronic nonspecific low-grade inflammation. The imbalance of immune cells exists in PCOS. Several studies have found that heat shock protein 70 (HSP70) may be involved in the immunological pathogenesis of PCOS, but the relationship between HSP70 and Regulatory T cell (Treg)/ T helper cell 17(Th17) ratio remains unclear. This study aims to explore the correlation between HSP70 and Treg/Th17 ratio, and to find out the role of HSP70 in the immunological etiology of PCOS.Results: There was no significant difference in age and body mass index (BMI) between two groups. The concentrations of basal estradiol (E2), basal follicle stimulating hormone (FSH) didn’t show significant difference between two groups. The concentrations of basal luteinizing hormone (LH) (P < 0.05), testosterone (T) (P < 0.01), glucose (P < 0.001) and insulin (P < 0.001) in PCOS patients were significantly higher than those in control group. The expressions of HSP70 were significantly higher in serum in the PCOS group (P < 0.001). The percentage of Treg cells was significantly lower (P < 0.05), while the percentage of the Th17 cells of the PCOS group was significantly higher than that of the control group (P < 0.05). The ratio of Treg/Th17 in PCOS group was significantly lower (P < 0.001). The concentrations of Interleukin (IL)-6, IL-17 and IL-23 were significantly higher, while the levels of IL-10 and Transforming growth factor-β (TGF-β) were significantly lower in PCOS group (P < 0.001). Spearman rank correlation analysis showed strong negative correlation of serum HSP70 levels with Treg/Th17 ratio, IL-10 and TGF-β levels. In contrast, HSP70 levels were significantly positively correlated with IL-6, IL-17, IL-23, LH, T, insulin, and glucose levels.Conclusion: The abnormal expression of HSP70 is correlated with Treg/Th17 imbalance and corresponding cytokines, which indicates that HSP70 may play an important role in PCOS immunologic pathogenesis.