Polycystic ovary syndrome (PCOS) is now globally recognized as the most common endocrinopathy in women of reproductive age and has a prevalence of 5–21% depending on the criteria used (NIH, Rotterdam or Androgen Excess Society). What is special about the syndrome is its dual entity involving both the reproductive and the metabolic profile of the women affected. As a result, any intrinsic or extrinsic factors affecting both these components could lead to pathophysiological alterations that characterize PCOS. In fact, the heterogenicity of the syndrome suggests that, apart from the genetic background, the role of the environment and a person’s lifestyle are equally important. In particular, during the last twenty years, interest has been drawn to the impact of certain environmental toxins, referred to by the terms “endocrine disruptors” or “endocrine disruptive chemicals” (EDCs), which may modify both reproductive and metabolic pathways. Western civilization advancements in industrial products and food processing have led to increased daily exposure to plasticizers, such as bisphenol A (BPA) and phthalates, as well as dietary glycotoxins, such as advanced glycation end products (AGEs), which may exert adverse effects on reproduction and metabolism throughout the female lifespan.