Objective: To determine the frequency of uterine abnormalities in PCOS patients compared to normo-ovulatory patients and their relationship to androgen levels. Design: Retrospective cohort study. Setting: Tertiary University Hospital Population: Total of 103 women, 51 PCOS, and 52 male factor infertility Interventions: HSG images of all patients were numbered and evaluated by ten senior reproductive endocrinologists blinded to the research and chose the most appropriate figure for each patient’s HSG image and marked the shape of cavity according to the ASRM and ESGE/ESHRE classification. Main outcome measures: Abnormal HSG Rates, serum AMH and androgen levels Results: The percentage of the normal uterine cavity was significantly lower in the PCOS group than control group as 51 % and 66.7 %, 77 % and 94.2 % according to the ASRM and ESHRE/ESGE classifications, respectively. The frequency of Partial Septate Uterus (ESHRE-ESGE U2a / ASRM Va, 21.6% vs 5.8 % p<0.05), Complete Septate Uterus (ESHRE-ESGE U2b / ASRM Vb, 7.8% vs 0% p<0.01) and Dysmorphic Uterus (ESHRE-ESGE U1c) / ASRM VII) 3.9 % vs 0 p<0.05) were significantly higher in PCOS patients than controls. The frequency of arcuate uterus classified as VI in ASRM and considered normal in ESHRE/ESGE was 16 % and 17.3 % in PCOS and control groups, respectively, without statistically significant difference. The increased frequency of intrauterine cavity abnormalities was correlated with serum-free testosterone levels. Conclusion: This study provides that the frequency of uterine cavity abnormality is clearly higher in PCOS patients compared to the healthy population.