INTRODUCTION: The aim of the study was to investigate homocysteine (Hcy) levels in polycystic ovary syndrome (PCOS) patients without insulin resistance (IR) and metabolic syndrome (MS). METHODS: This retrospective study involved 64 patients aged between 18-35 years who applied to the tertiary clinic between March 2022 and March 2023. A total of 32 PCOS patients without IR and MS and 32 healthy women were enrolled in the study. All participants underwent history taking, clinical physical examination, gynecological ultrasonographic evaluation, and laboratory tests. Laboratory screening tests, including follicle-stimulating hormone (FSH), luteinizing hormone (LH), total testosterone (T), free T, sex hormone-binding globulin (SHBG), dehydroepiandrosterone sulfate (DHEAS), and low-density lipoprotein (LDL), were performed. Normal insulin sensitivity was defined based on fasting serum glucose, fasting insulin level, serum insulin response to an oral glucose tolerance test, and the homeostatic model of insulin resistance. Results: There were no differences in terms of age, systolic and diastolic blood pressure, FSH, LH, total T, free T, SHBG, DHEAS, and LDL between the groups. PCOS patients had increased Hcy, waist-to-hip ratio (WHR), and body mass index (BMI) compared to the control group. Hcy was positively correlated with WHR and BMI. A strong correlation was found between Hcy and PCOS. DISCUSSION AND CONCLUSION: Elevated Hcy is associated with cardiovascular risk factors in PCOS patients without IR and MS.