Background: Polycystic ovary syndrome (PCOS) is one of the most frequent endocrinopathies in women in reproductive age.  the  clinical  image of the disease   is heterogeneous. Hirsutism is one of the   gynecological symptoms of PCOS with  prevalence ranging from 70-80% in affected cases.   
Objective: To assess the effect of chromium salts in addition to metformin on hirsutism scoring and Body Mass Index in polycystic ovary syndrome patients. 
Methods: This double blinded randomized controlled trial at Ain Shams University Maternity Hospital included sixty cases of PCOS complaining of hirsutism, age between 18 and 40 years were included, while Patients   known   to   be   diabetic, hypertensive, receiving    corticosteroids, psychotropic drugs, diuretics, Ovulation  induction drugs, known hypersensitivity or contraindications to the used medications or those who used permanent methods of hair removal were excluded.  . The patients were randomly divided into two equal groups. Group S were thirty cases who received metformin and chromium picolinate and Group C were thirty cases receiving metformin and placebo in the form of vitamin C retard. 
Results: There was a highly  statistically  significant  difference  between two  groups as regard weight  loss, BMI, hirsutism score and menstrual regularity in favor  to intervention group  after  4 months follow up as p- value  was <0.001. There was No significant difference between two groups as regard side effects reported about the drugs as p-value was >0.05.  
Conclusion: Adding chromium picolinate to metformin in PCOS patients caused further improvement of Hirsutism score and regularity of menses, and further decrease in BMI.