Background: Polycystic Ovary Syndrome (PCOS) is a prevalent endocrine disorder among women of reproductive age, commonly associated with hyperandrogenism, menstrual irregularities, and dermatological manifestations such as acne. Objective: This study aimed to investigate the prevalence of acne among women with PCOS and explore its association with hormonal imbalance in among some women from Tripoli, Libya.. Methods: A cross-sectional study was conducted among 100 women attending outpatient clinics in hospitals in Tripoli, Libya. Data were collected using a structured questionnaire administered through face-to-face interviews, focusing on demographic characteristics, PCOS-related symptoms, family history, and awareness of hormonal factors. Results: The majority of participants were aged 20–29 years (68%). Acne during the menstrual cycle was reported by 75% of respondents, while 78% experienced irregular menstrual periods, and 87% reported unusual hair loss. A family history of PCOS was present in 72% of participants, and 66% had been previously diagnosed with polycystic ovaries. Awareness of PCOS was moderate, with 60% recognizing the role of androgen excess. Conclusion: The findings demonstrate a strong association between PCOS and acne among Libyan women, highlighting the need for improved awareness, early diagnosis, and targeted management strategies to address both reproductive and dermatological outcomes.................. Keywords:...............Acne, PCOS, hyperandrogenism, hirsutism, insulin resistance, chronic anovulation, menstrual irregularities.