Abstract Disclosure: N. Priya: None. L. Brenan: None. Y. Luu: None. L. Hull: None. A. Short: None. N. Gupta: None. A.S. Pena: None. Polycystic ovary syndrome (PCOS) is a common endocrine condition affecting up to 13 and 18 % of women and adolescents. Women with PCOS have reduced quality of life and increased rates of depression and anxiety, but there is limited data in adolescents of all ranges of body mass index (BMI). Therefore, this study aimed to assess quality of life, depression, anxiety and stress levels of adolescents with PCOS of all BMI ranges. This cross-sectional study included participants aged between 12 and 22 years old who had been diagnosed with PCOS using the 2020 adolescent international evidence-based guidelines. Participants completed three self-administered questionnaires (Depression, Anxiety and Stress questionnaire, Pediatric Quality of Life, and PCOS-specific quality of life (PCOSQ)). Clinical data was also collected. Seventy-six adolescents with PCOS were enrolled into the study (mean age [standard deviation] 17.3 [2.1] years, mean age of menarche 12.06 [2.1] years old and the mean time since PCOS diagnosis 0.8 [1.4] years). Mean BMI was 29.8 [8.2] kg/m2 (21 had a BMI <85th percentile for age and gender). Participants scored 13.7 [9.8] for depression, 13.8 [9.1] for anxiety and 17.6 [8.8] for stress. 36 participants scored ≥14 and 47 participants scored ≥10 indicating moderate levels of depression and anxiety, respectively. For quality of life (scored out of 100 with a higher score indicating better quality of life), participants scored 68.9 [16.3] in the domain of physical functioning, 49.5 [20.4] for emotional functioning, 75.3 [21.6] for social functioning and 57.8 [21.5] for school functioning with a total average score of 63.8 [15.4] which indicated an above average quality of life. For the PCOSQ (highest score is 7 which indicates a higher quality of life) participants scored 4.2 [1.4] for emotions, 4.0 [1.8] for body hair, 3.4 [2.0] for weight, 3.9 [1.4] for menstrual problems and 5.2 [1.6] for infertility problems. Higher BMI significantly related to lower Pediatric Quality of Life total score (r=-0.44, p<0.001) and PCOSQ for weight (r=-0.55, p<0.001), but did not impact other PCOSQ domains. BMI was not related to depression, anxiety and stress scores. Adolescents with BMI ≥85 percentile have worse total PCOSQ scores compared to those with BMI <85 percentile (3.8 (1.2) vs 4.9 (0.9), p=0.008). Better PCOSQ for emotions significantly related to better Pediatric Quality of Life total score (r=0.47, p<0.001) and other domains of PCOSQ (PCOSQ for body hair r=0.48, p<0.001; for weight r=0.46, p<0.001; for menstrual problems r=0.58, p<0.001 and for infertility r=0,73, p<0.001). Higher BMI was associated with reduced quality of life in adolescents recently diagnosed with PCOS, but other factors that impacted quality of life were hirsutism, menstrual irregularities and infertility. Presentation: Thursday, June 15, 2023