Objective: To test the hypothesis that the dietary intake and dietary composition of women with polycystic ovary syndrome (PCOS) is associated with indices of glycemic status. We hypothesized that women with PCOS would consume a diet higher in total energy, fat, and specific foods with a high glycemic index than would healthy, control-group women and that dietary composition would be associated with indices of insulin resistance and secretion among women with PCOS. Design: Cohort study. Setting: Research center on a university campus. Patient(s): Thirty women with PCOS and 27 healthy, age-, race-, and body mass index (BMI)-matched control women. Intervention(s): None. Main Outcome Measure(s): Nutrient intake data were collected from a food questionnaire and a 4-day food record. Fasting sera were analyzed for concentrations of insulin and glucose; estimates of insulin resistance were calculated. Result(s): Consumption of total energy, macronutrients, micronutrients, and high glycemic index foods was similar between the groups. However, the PCOS group consumed significantly more white bread (7.9 ± 4.4 vs. 5.5 ± 2.9 servings over 4 days) and tended to consume more fried potatoes than did the control group (1.0 ± 1.5 vs. 0.4 ± 0.7 servings over 4 days). The PCOS group had a significantly greater fasting insulin concentration (22.5 ± 14.9 vs. 15.1 ± 8.3 μIU/mL) and a significantly lower glucose-to-insulin ratio (4.7 ± 2.1 vs. 7.6 ± 5.2) than the control group. Within the PCOS group, HOMA-IR and HOMA-%β-cell function were significantly associated with BMI. The HOMA-IR, HOMA-%β-cell, fasting insulin, and glucose-to-insulin ratio were not positively associated with measures of diet composition. Conclusion(s): Compared with matched control women, women with PCOS exhibited a dietary pattern that was marked by consumption of a greater amount of specific foods with a high glycemic index; however, diet composition was not associated with the greater fasting insulin concentration or with lower glucose-to-insulin ratio that was observed in the PCOS group. © 2006 American Society for Reproductive Medicine.