Background: The most frequent cause of infertility, hyperandrogenism, and ovulatory problems is polycystic ovarian syndrome (PCOS). One of the most common diseases in the world. Management of insulin resistance, which is based on dietary habits, exercise, and other molecules like inositol, is crucial in the treatment of PCOS. In polycystic ovary syndrome, inositol is useful in restoring ovarian function and enhancing oocyte and embryo quality. Objective: Comparison of the effectiveness of choline and inositol vs metformin and non-insulin sensitizers in polycystic syndrome patients. Materials and Methods: A case-control research carried out in the Iraqi city of Nasiriyah from March 2021 to December 2021. There were 150 PCOS patients. There were three categories of patients: Metformin with clomiphene citrate in Group 1, choline and inositol with clomiphene citrate in group 2 and clomiphene citrate alone in group 3. Six months of drug therapy were provided to all groups, followed by evaluation. Results: During follow-up, mean BMI decreased significantly by an average of 1.9 ± 4.2 kg/m² (p = 0.001). Regarding cycling, regular cycling was significantly higher in the metformin group (p = 0.001). The mean change in follicle size was 2.9 mm, which decreased significantly after treatment initiation (p=0.001).  Both LH and FSH increased significantly after treatment initiation (p=0.0001). Subsequent LH distribution was not significantly different between the drug groups (p=0.5), whereas subsequent FSH distribution was significantly higher in the metformin group (p=0.04). Although women taking choline and inositol + clomiphene citrate or metformin + clomiphene citrate were more likely to conceive than women taking clomiphene citrate alone, there was no significant difference between the two groups (p = 0.19). Conclusion:There were no notable differences between any of the groups in terms of the respective medicines. There were no discernible differences between the two groups, despite the fact that women using either metformin or choline and inositol were more likely to become pregnant than those in the third group.