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Objective: To assess the role of neck circumference (NC) in assessing insulin resistance (IR) in polycystic ovary syndrome (PCOS).Design: A cross-sectional study.Setting: University-affiliated hospital.Patient(s): One hundred forty-three women with PCOS were recruited from November 2018 to February 2020.Intervention(s): None.Main Outcome Measure(s): The associations of NC with IR and the cutoff points of NC for IR.Result(s): The prevalence rates of IR were 64.3%. The patients with PCOS with IR had significantly greater values of systolic blood pressure, NC, body mass index, waist-to-hip ratio, waist circumference, fasting blood glucose, fasting insulin, and homeostasis model assessment of insulin resistance (HOMA-IR). Pearson correlation analysis showed body mass index (log-transformed), waist circumference, waist-to-hip ratio, and HOMA-IR (log-transformed) were positively correlated with NC. Multivariable linear regression showed that NC was significantly associated with HOMA-IR (log-transformed), with the standardized regression coefficient of 0.330 with adjustment for potential confounding factors. Furthermore, multivariate logistic regression analyses showed NC was associated significantly with increased risk of IR, with the adjusted odds ratio of 1.423. Additionally, NC was able to identify IR in women with PCOS; the optimal cut-off points was 34.3 cm (Youden index = 0.586).Conclusion(s): Neck circumference is positively associated with IR in women with PCOS. We suggest NC as a novel, simple, practical, and reliable anthropometric measure to be used to predict the risk of IR in patients with PCOS. [ABSTRACT FROM AUTHOR]