To evaluate the effects of metformin on the ovarian stromal blood perfusion in the patients with polycystic ovary syndrome (PCOS). Twenty-five women with PCOS who underwent a Doppler examination of the ovarian stroma was evaluated; hormonal, anthropometric, and biochemical parameters of patients were determined. After the patients were treated with 850 mg metformin twice a day for 6 months, the same parameters were evaluated in the same patients. After metformin treatment, although pulsatility index (PI) was increased from 1.80 +/- A 1.23, 1.84 +/- A 1.28 to 2.20 +/- A 1.10, 2.19 +/- A 0.83 in the right and left ovary, respectively, and resistance index was increased from 0.84 +/- A 0.25, 0.83 +/- A 0.23 to 1.16 +/- A 0.37, 1.10 +/- A 0.26 in the right and left ovary respectively (P < 0.05), peak systolic velocity (PSV) was decreased from 12.30 +/- A 1.72, 12.34 +/- A 1.55 to 10.25 +/- A 0.97, 10.53 +/- A 1.33 in the right and left ovary respectively (P < 0.05). PI and RI did not show any difference between the homeostatic model assessment insulin resistance index (HOMA-IR) a parts per thousand yen 2.38 and HOMA-IR < 2.38 groups before and after metformin treatment (P > 0.05). However, PSV was decreased significantly from 13.05 +/- A 1.35, 12.82 +/- A 2.02 to 11.03 +/- A 0.71, 10.25 +/- A 0.42 in HOMA-IR a parts per thousand yen 2.38 group in the right and left ovary, respectively, and PSV was decreased from 11.50 +/- A 2.67, 11.28 +/- A 0.26 to 9.10 +/- A 0.58, 9.28 +/- A 0.25 in HOMA-IR < 2.38 group in the right and left ovary, respectively, before and after metformin treatment (P < 0.05). PSV for both ovaries were positively correlated with HOMA scores before and after metformin treatment [(r = 0.713, P = 0.000; r = 0.617, P = 0.04 and r = 0.635, P= 0.03; r = 0.483, P = 0.031 respectively]. Metformin treatment affected ovarian stromal blood flow in PCOS patients.