Abstract: Method: Standards for this audit were set from the ESHRE 2018 PCOS guideline.These included assessment for diagnosis, cardiovascular risk, quality of life, mental health, and management of PCOS.The assessment of 50 patients aged 14-21 seen in the adolescent gynae-endocrine clinic for suspected PCOS between 2014 and 2021 at Cambridge University Hospitals were compared against these standards.Results: 15% of adolescents diagnosed with PCOS did not meet diagnostic criteria and 65% of those diagnosed 'at risk of PCOS' met diagnostic criteria.An ultrasound was requested in 80% of patients to confirm diagnosis against guideline recommendations.92% were assessed for hirsutism and 78% were assessed for acne.Topical treatments were discussed with less than 30%.Other results showed the assessment of cardiovascular risk, lifestyle changes, pharmacological intervention and follow up could be markedly improved.No patients were assessed for psychological impact. Conclusion:The ESHRE guideline clearly sets out diagnostic criteria and describes the management of reproductive, metabolic, and psychological sequelae for adolescents with or at risk of PCOS.Our results show that diagnosis and management could be improved.Education is key.We have presented findings at our local endocrinology meeting and will also conduct a regional teaching session for gynaecology trainees.Although limited to clinic documentation, our results suggest that a proforma including all domains of assessment (diagnosis, cardiovascular risk, quality of life, mental health) and management may enable a more holistic review in clinic, acting as a guide to recall the many aspects of care to cover in a time-pressured NHS-clinic setting.Proformas have now been implemented at our trust for use in gynaecology and endocrine clinics.If successful, this proforma could be disseminated nationally improving the accuracy of diagnosis and ensuring all aspects of management, each with important lifelong consequences, are fulfilled.