Abstract Disclosure: S. Livadas: None. B.O. Yildiz: None. G. Mastorakos: None. A. Gambineri: None. D.L. Pignatelli: None. F. Giorgino: None. M. Andersen: None. B.M. Obermayer-Pietsch: None. D.P. Macut: None. Background: Although polycystic ovary syndrome (PCOS) constitutes a common endocrinopathy, there are several issues which confuse clinicians during everyday practice.Objective: To define the current status of knowledge of the full spectrum of PCOS among European endocrinologists. Methods: A detailed questionnaire comprising 41 items covering various aspects of diagnosis and management of women with PCOS was shared via web among members of European Society of Endocrinology. Results: 505 European endocrinologists (64% females), with a mean age of 47±11.6 years answered the questionnaire. Rotterdam criteria were used by 85% of endocrinologists. The most frequent age at referral was between 20-40 years (87.1%). A quarter of doctors have access to mass spectrometry for the evaluation of androgen levels. Extended metabolic profile was part of workup by the vast majority, but there was significant uncertainty regarding the diagnosis of chronic anovulation. Diabetes, gestational or type 2, was considered a major consequence for women with PCOS and screening is carried out regardless of BMI status. Lifestyle modification and metformin are considered a standard approach of all participants and oral contraceptives are a standard therapeutic modality, but there is significant discrepancy on the duration of treatment.Conclusions: Rotterdam diagnostic criteria are currently an established diagnostic approach within the European endocrine community. This updated survey showed an advance in using steroid profiling for diagnosis and strong position on recognizing PCOS as a metabolic condition with potential broader consequences. Therapeutic aspects are currently changed into the need for more lifestyle intervention involvement and the use of metabolic therapies either as monotherapy or in combination with standard hormonal compounds. Presentation: 6/3/2024