Polycystic ovary syndrome (PCOS) is a multifactorial endocrine disorder affecting reproductive, metabolic, and psychological health in women of reproductive age. Its complex pathogenesis involves insulin resistance, hyperandrogenism, and chronic low-grade inflammation. Diet and lifestyle interventions play a central role in PCOS management, particularly in improving insulin sensitivity, regulating hormonal function, and reducing cardiometabolic risk. Among the non-pharmacological approaches, inositol supplementation—particularly with myo- inositol (MI) and D-chiro-inositol (DCI)—has gained considerable interest. These stereoisomers are involved in insulin signaling, glucose metabolism, and ovarian function. The present work summarizes current dietary recommendations for women with PCOS and reviews available clinical evidence on inositol’s therapeutic potential. While several studies report positive effects on ovulation, metabolic parameters, and hormonal balance, recent meta-analyses reveal inconsistent findings. Most trials confirm the safety and tolerability of inositol, and some suggest comparable outcomes to metformin in selected populations. Although inositol cannot yet be considered a definitive therapy, it appears to be a promising, well- tolerated supplement that may complement dietary and lifestyle strategies. Based on current evidence, its clinical use should be personalized and accompanied by further research. This paper highlights the importance of an integrated, evidence-based approach to PCOS treatment, emphasizing the role of nutrition and the potential value of inositol in improving patient outcomes.