Background: Polycystic ovarian syndrome (PCOS) is one of the most prevalent endocrine and metabolic conditions in premenopausal women. Objectives: The goal of this study was to see the efficacy of Letrozole in conjunction with clomiphene citrate versus Letrozole alone in inducing ovulation in PCOS patients. Patients and methods: This was a randomized clinical trial (RCT) done on a total of 200 patients who came to South Valley University, Obstetrics and Gynecology clinics, after receiving the ethical committee permission and signed informed consent from all participants. Results: Regarding all treatment outcomes, there were no statistically substantial difference among the two groups as regards the following parameters: ovulation, mature follicle number, endometrial thickness, OHSS, single pregnancy, clinical pregnancy, multiple pregnancy and miscarriage, P>0.05. Conclusion: this research showed that in terms of infertility therapy in women with PCOS, the combination of letrozole and CC was linked to"Although there is absolute difference between the two groups in favor of the combined use of letrozole plus clomiphene citrate, this difference is not statistically significant". These new findings indicate that this combined therapy might be a low-risk, low-cost infertility treatments.