Background: Polycystic ovarian syndrome (PCOS) represents the most common endocrine pathology in women of reproductive age globally. There is a link between vitamin D deficiencies; lower levels of L-carnitine and PCOS. The purpose of this study is to see how L-carnitine and vitamin D supplementation affects intracytoplasmic sperm injection outcomes in patients with polycystic ovarian syndrome. Patients and methods: The current study included (40) PCO patients who were arranged to perform ICSI owing to resistance to various methods of induction of ovulation. They were divided into two groups; Group (I) involved patients received 3 grams l-carnitine with 20mcg vitamin D3 daily for 3 months before the ICSI cycle and during the ICSI cycle till the time of HCG measurement. Group (II) involved (20) patients who didn't receive L-carnitine and vitamin D3 neither before nor during ICSI cycle. The patients in this group continued receiving traditional metformin. Results: After treatment, there was a significant decrease in HOMA IR in group I more than group II (p 0.01), and a significant decrease in HOMA IR after treatment in group I compared to group II (p 0.05). There was a significant increase in number of oocytes; the mean number of M2 oocytes and the mean injected number of oocytes in group I more than group II. Furthermore, the high quality of embryos and the pregnancy rate showed a significant increase in group I more than group II. Conclusion: This study's findings add clinical support to the evidence that vitamin D and L-carnitine may play a role in intracytoplasmic sperm injection success rates in PCOS patients.