Background: Polycystic ovary syndrome (PCOs) is a common genetic and endocrine disorder affecting 5-10% of women at reproductive age. Aim was to assess pregnancy outcomes of pregnant women with PCOs. Subjects and methods: Comparative descriptive cross-sectional study design was conducted in the labor ward of Obstetrics and Gynecology, Qena University and Qena General Hospital. Convenient sample were 120 pregnant women with PCOs and other 600 pregnant women without PCOs. Data collected by structured interview questionnaire, maternal and neonatal assessment sheet. Results of the study found that pregnancy with PCOs was associated with significantly higher rates of maternal complications as hypertension (14.2%), gestational diabetes mellitus (10.8%), preeclampsia (4.2%), preterm delivery (5%) and cesarean delivery (79.2%) versus (0.7%), (0.7%), (2.3%), (1.7%) and (53.8%) in the non PCOs group. Neonatal complications as APGAR score of less than 7 (19.2%), macrosomia (9.2%), respiratory distress (20.8%) and admission to neonatal intensive care unit (4.3%) versus (2.2%), (3.2%), (6.2%) and (20.8%) in the non PCOs group with highly statistical significant relationship among both groups. Conclusions: This study confirmed higher association of pregnancy complications among PCOs group compared with non PCOs group. Recommendations: women with PCOs should be followed up for complications on pregnancy and neonatal outcomes.