Background: Polycystic ovary syndrome (PCOS) is a common endocrinal disorder of reproductive aged females. There are many causes of hair loss that could affect females including androgenetic alopecia (AGA), alopecia areata (AA), telogen effluvium (TE), trichotillomania (TTM) and lichen planopilaris (LPP). Objective: To assess the prevalence of different causes of hair loss among ‎females with PCOS in Delta area-Egypt. Patients and Methods: This observational cross-sectional study included 246 patients with PCOS and were classified into 5 groups, group (A) included patients with PCOS with no hair loss (normal) hair, group (B) included patients with PCOS and AGA, group (C) included patients with PCOS and AA, group (D) included patients with PCOS and other causes of hair loss and group (E) included patients with more than one type of causes of hair loss. Results: There were statistically significant associations between AGA and the causes of hair loss ‎and menstrual irregularities (p=0.005), puberty onset (p < 0.001), and family ‎history. ‎No significant associations were detected between groups ‎with hair loss regarding acne vulgaris (AV), seborrhea, hirsutism, ‎high-pitched voice, decreased breast mass, masculine body and body hair ‎hypertrichosis (p>0.05) except for hirsutism was more in TE and psychological disturbances were more in TTM. Conclusion: Hirsutism, AV, AGA and seborrhea have strong association with ‎PCOS in current study. AGA is accompanied by other manifestations ‎of clinical hyperandrogenism but doesn't seem to be accompanied by greater risk of biochemical alterations than PCOS alone. ‎AGA is the most commonest prevalent clinical manifestation of hair loss ‎in our study.