Background: Infertility is a prevalent concern affecting numerous couples worldwide, often caused by anovulation or irregular ovulation. Induced ovulation using pharmacological agents, such as letrozole and clomiphene citrate, is a commonly employed approach to enhance fertility. However, the impact of these medications on endometrial receptivity, a critical factor for successful implantation and pregnancy, remains an area of ongoing research. The primary goal of this research was to compare endometrial receptivity during induced ovulation by letrazole or clomiphene citrate. Methods: This study was prospective comparative research where 120 PCO and infertility more than 1-year women were included and divided into 2 groups: Group A (Clomid induction group) (odd numbers); Results: The results demonstrate significant differences in endometrial thickness among the two groups. On the 11th day of the cycle, Group B exhibited a significantly higher endometrial thickness (9.82 ± 0.21 mm) compared to Group A (7.00 ± 0.21 mm) (T = -73.53, p < 0.0001). Similarly, at the stage of mature follicle (follicle > 18mm), Group B showed a significantly greater endometrial thickness (10.22 ± 0.20 mm) compared to Group A (7.49 ± 0.20 mm) (T = -73.49, p < 0.0001). Furthermore, even 7 days after ovulation, Group B maintained a significantly thicker endometrium (10.65 ± 0.22 mm) compared to Group A (7.81 ± 0.20 mm) (T = -74.33, p < 0.0001). Conclusions: Letrozole induces a greater rise in endometrial thickness and conception rate than Clomiphene citrate in infertile PCOS women.