<p>Polycystic ovary syndrome (PCOS) is a highly prevalent endocrine and metabolic disorder in women of reproductive age. Its multifactorial pathogenesis involves complex interactions among genetic patterns, environmental factors, insulin resistance (IR), chronic inflammation, and persistent oxidative stress, collectively manifesting as reproductive, metabolic, and psychological dysfunctions. This review systematically evaluates recent advances in the application of natural products as multi-targeted adjunctive therapeutic strategies for PCOS, to provide critical translational insights. Accumulating evidence from preclinical and clinical frameworks demonstrates that natural products exert beneficial regulatory effects by suppressing inflammatory cascades, mitigating oxidative damage, restoring insulin signaling, rebalancing steroidogenesis, and normalizing gut microbiota composition. These plant-derived therapies offer broader biological regulatory windows that effectively complement conventional management protocols, such as oral contraceptives, insulin sensitizers, and ovulation inductors. However, translating these promising agents into standardized clinical care remains restricted by substantial challenges, including pronounced study heterogeneity, uncharacterized pharmacokinetic profiles, a lack of standardized dosing, and incomplete long-term toxicological evaluations. Future well-designed, multi-center clinical trials and systems biology approaches are mandatory to establish the therapeutic robustness and chemical standardization required for clinical implementation.</p>