Background <p>Polycystic ovary syndrome (PCOS) is the most prevalent endocrine disorder affecting women of reproductive age globally, with significant variations in clinical presentation across different populations. In Nigeria, PCOS represents a major cause of infertility and metabolic dysfunction, yet comprehensive understanding of diagnostic and predictive biomarkers remains limited.</p> Objective <p>This narrative mini-review synthesizes current evidence on diagnostic and predictive biomarkers of polycystic ovary syndrome (PCOS), with emphasis on their relevance in the Nigerian healthcare context.</p> Methods <p>Literature was identified through structured searches of PubMed, Scopus, and Google Scholar using predefined keywords related to PCOS, biomarkers, diagnosis, prediction, and Nigeria.</p> Results <p>PCOS is a heterogeneous endocrine-metabolic disorder characterized by hyperandrogenism, ovulatory dysfunction, and polycystic ovarian morphology. While established international diagnostic criteria remain clinically based, emerging biomarkers including anti-Müllerian hormone (AMH), insulin resistance indices, inflammatory markers, adipokines, and oxidative stress parameters provide additional insights into pathophysiology and phenotypic variation.</p> Conclusion <p>A combined biomarker approach may provide complementary information regarding PCOS pathophysiology and metabolic risk stratification; however, further validation studies are required before such panels can be considered for routine diagnostic use. Strengthening Nigeria-specific research and improving biomarker validation within local populations remain critical priorities.</p>