Background: Polycystic ovarian syndrome (PCOS) is the most common endocrine abnormality in women of reproductive age with a prevalence of 5-10% in different populations. The prevalence of PCOM in patients with PCOS has been shown to be ≥ 90% in different populations. Diagnostic evaluation accounts for a relatively minor part of the total costs of providing care and evaluating women with PCOS. Hence more widespread and liberal screening for the disorder appears be a cost-effective strategy in susceptible patients. PCOM on ultrasound is diagnosed if one of the following is present in one or both of the ovaries; Ovarian volume of more than or equal to 10 cc, more than 12 ovarian follicles 2-9 mm in diameter. Ovarian volume on ultrasound is easy to measure and has good reproducibility compared to follicle number. Primary Objective: To determine the correlation between ovarian volume as seen on ultrasound and polycystic ovarian syndrome. Study design: Cross sectional study with retrospective collection of data at the Aga Khan University Hospital (AKUH), Nairobi Kenya. Results: Data from 206 patients meeting the inclusion and exclusion criteria was analyzed. The point biserial correlation coefficient was 0.2561 (t statistic = 3.78, p = 0.0002). We further calculated the mean ovarian volume difference between the two groups which was -2.53 (95% CI -3.72 to – 1.34). Multivariable logistic regression model was run, ovarian volume was significantly associated with PCOS (p = 0.003), with the risk of PCOS increasing by 15% (AOR 1.15, 95% CI 1.05-1.26) for each unit increase in ovarian volume. Distribution of BMI in patient’s diagnosed with polycystic ovarian syndrome was as follows; 56.6% overweight, 34.5% normal BMI and 8.8% obese. Conclusion: We have shown that transvaginal ultrasound has clinical utility in the prediction of PCOS. Our findings can be applied to the local general