Objective To correlate hemostatic parameters with clinical markers of fat distribution and laboratory variables in women with polycystic ovary syndrome (PCOS) compared with healthy control subjects. Design Cross-sectional study. Setting Tertiary teaching hospital. Patient(s) Forty-five women with PCOS and 45 control women matched for age and body mass index (BMI). Intervention(s) Clinical evaluation and venipuncture. Main Outcome Measure(s) Age, BMI, waist circumference (WC), hip circumference (HC), waist-hip ratio (WHR), Ferriman-Gallwey index, fasting glucose, fasting insulin, total testosterone, free testosterone (FT), thrombin-activatable fibrinolysis inhibitor (TAFI), D-dimer, plasminogen activator inhibitor (PAI) 1, and the parameters of thrombin generation test (TGT), including the lag time (Tlag), time to peak thrombin generation (Tmax), peak concentration (Cmax), and the area under the thrombin generation curve (TAUC). Result(s) In the PCOS group, BMI and WC correlated positively with TAFI, D-dimer, PAI-1, Cmax, and TAUC; HC with D-dimer and PAI-1; WHR with TAFI, D-dimer, and PAI-1; glucose with TAFI; insulin and homeostasis-model assessment of insulin resistance with PAI-1; and FT with Cmax and TAUC. Age correlated positively with D-dimer and PAI-1, and negatively with Tlag and Tmax. In the control group, there were no correlations between clinical markers of fat distribution and hemostatic parameters, but age and fasting glucose correlated positively with PAI-1, and FT with Tmax and TAUC. Conclusion(s) In PCOS, android body fat distribution may directly affect hemostatic parameters, particularly in young and overweight women. Further studies are needed to establish a correlation between these results and an increase in thromboembolic risk.