Abstract: Polycystic ovarian syndrome (PCOS) is a common female reproductive endocrine disorder. Based on the syndrome differentiation and treatment from Xuanfu theory, it is believed that the basic pathogenesis of PCOS is the Xuanfu stagnation, combined with the improper functioning of qi, blood and fluids. Therefore, as for the treatment of PCOS, acrid medicinals can be used to directly unblock the Xuan. Then according to the pathogenesis priority of qi-depression, phlegm-dampness, and blood stasis, corresponding therapies including promoting qi movement, dissolving phlegm, as well as dispelling stasis can be applied to unblock the Xuanfu, promote the flow of qi and fluid, and restore the normal physiological function of the Xuanfu with reasonable medicinal combinations. The study not only expands the scope of application of Xuanfu theory, but deepens the understanding of the PCOS etiology and pathogenesis. Besides, it provides new ideas and methods for the syndrome differentiation and treatment of PCOS.