Abstract：The intestinal microbiota is the largest microbial community in the human body，which participating in the metabolism of nutrients in the body， and is known as the "second genome" of humans. The imbalance of the intestinal microbiota can affect the functions of the host's nervous， endocrine， and immune systems， as well as the digestive and absorptive capacity of the gastrointestinal tract，mediating the occurrence of a series of diseases. Related studies have shown that the intestinal microbiota is closely related to the pathogenesis of polycystic ovary syndrome （PCOS） and can participate in the development of PCOS by regulating the levels of steroid hormones，insulin resistance， inflammation， and obesity in the body. Based on this， this paper reviews the mechanism of intestinal microbiota regulation in PCOS and the current research status of Chinese medicine intervention in the intestinal microbiota for the prevention and treatment of PCOS. It proposes that "the spleen governs transportation and transformation" and "the heart is paired with the small intestine" may be the manifestations of macro Chinese medicine theory in the influence of intestinal microbiota on PCOS，providing new ideas for the prevention and treatment of PCOS with Chinese medicine.