Background: Polycystic ovary syndrome (PCOS) is a common complex; heterogeneous endocrine disorder characterized by irregular menses, hyperandrogenism, and infertility. Aims: To study the outcome of laparoscopic ovarian drilling in clinical presentations in form of cycle pattern, acne & Hirsiutism in addition to their conception among infertile Sudanese patients with PCOS.Methods: A hospital based cohort study which was conducted in two hospitals in Khartoum state, Sudan; Omdurman Maternity Hospital & Saad Abu Elela hospital from January to December 2018.Targeted 145 infertile patients diagnosed as PCOS based on Rotter-Dam criteria 2003 definition and who did not conceive after diet, lifestyle and clomiphene; underwent laparoscopic ovarian drilling (LOD).data was collected using semi-structured questionnaires before the drilling ,then the patient was followed in 3 month time concerning the Clinical Presentations, and Conception Results: 65(44.8%) out of 145 infertile patients age was between 21-30 yrs, 67(46.2%) were obese with BMI >30; 90 (62.1%) of participants had irregular cycle., Hirsiutism was seen in 55 (37.9%) and acne was observed in 89 (61.4%). After laparoscopic drilling, 55.2% of patients had normal cycle pattern, amenorrhea & menorrhagia dropped to 3.5% & 11.7% respectively. About 46.2% had normal weight .Acne was seen in 32(22.2%) & Hirsiutism present in 42(19.3%) and 43 (29.6%) get pregnancy, BMI, acne & Hirsiutism before and after LOD were correlated using Chi square P value was 0.001, 0.002, and 0.007 respectively which was significant at (P ≥0.05). Conclusion: The path physiology of PCOS improves, after LOD concerning clinical presentations, & conception. Management of PCOS is essential to address patient concerns, prevent metabolic, & endocrine complications.