Background: PCOS, considered to be a common endocrinological disorder of females of reproductive age is often associated with obesity, dyslipidemia, hyperandrogenism, metabolic syndrome and infertility. Adipokines levels in PCOS is also reported to be altered may play a key role in obesity and dyslipidemia and insulin resistance. This study explored the relation among Adiponectin to Resistin Ratio, Tryglyceride to HDL cholesterol, HOMA IR and BMI. Materials & Methods: In this cross sectional comparative study 144 PCOS patients were included. Anthropometric and Biochemical parameters were evaluated. Patient population was categorized into Obese and No-obese groups depending on BMI and all the parameters were compared. Correlation among Adiponectin to Resistin Ratio, Triglyceride to HDL cholesterol, HoMA IR and BMI was assessed. Result: Significant difference was observed between lipid profile of Obese and Non-Obese groups. TG: HDL Ratio also had strong association (r = 0.79) with BMI. A:R Ratio and TG: HDL Ratio correlated significantly (r= - 0.78). HOMA IR had moderate correlation with BMI (p = 0.54), A:R Ratio ( r = -0.41) and TG: HDL Ratio (r = 0.59). Conclusion: In Obese PCOS patients Adiponectin and Resistin decrease significantly and A:R Ratio decrease significantly exposing the subjects to the more cardio-metabolic risk. TG: HDL Ratio can predict A:R Ratio, independent of HOMA IR.