Background: Polyendocrine Metabolic Ovarian Syndrome (PMOS), previously known as Polycystic Ovary Syndrome (PCOS), is a prevalent endocrine disorder among women of reproductive age. Individualized treatment strategies may address underlying constitutional factors. Homoeopathy employs a personalized constitutional approach and may provide an alternative therapeutic option. Objective: To describe the homoeopathic management of two cases of PCOS treated with Pulsatilla pratensis as the similimum, with outcomes evaluated through pre- and post-treatment ultrasound imaging. Methods: Two women with ultrasound-confirmed PCOS, irregular menstruation, and clinical features corresponding to Pulsatilla received individualized homoeopathic prescriptions. Detailed case-taking and repertorization informed remedy selection. Patients underwent serial clinical follow-up and repeated transvaginal ultrasound assessments to monitor ovarian morphology and follicular patterns. Results: Both patients demonstrated significant clinical improvement within a year. Menstrual cycles became regular, symptoms decreased, and follow-up ultrasonography indicated resolution of polycystic ovarian morphology, supporting the clinical response to individualized Pulsatilla pratensis treatment. Conclusion: These cases indicate that Pulsatilla pratensis, when prescribed based on the totality of symptoms, may be effective in managing PCOS. Larger controlled studies are required to confirm these findings.