Introduction: Polycystic ovary syndrome (PCOS) in adults is diagnosed based on clinical, biochemical, and radiological criteria, although in adolescents, some of these criteria may overlap with the normal process of puberty, which may lead to difficulty in diagnosis of this syndrome. This review is an evolutionary approach for diagnostic criteria of PCOS in adolescents. Material and Methods: In this study, Google Scholar, SID, Magiran, PubMed, Scopus, and Web of Science databases were searched for retrieving articles published up to August 2019 in the term of PCOS diagnostic criteria in adolescent females. Results: So far, researchers and scientific societies of gynecology, pediatrics, and endocrinology, have described several criteria for the diagnosis of PCOS in adolescents. According to available scientific evidence, it is necessary to clarify the diagnostic standards for all three clinical, laboratory and radiological criteria to prevent false diagnosis of this syndrome in adolescent females. Conclusion: Although evidence suggests that the risk of complications of PCOS may be reduced by accurately diagnosing and early treating in adolescence, the diagnostic criteria are still unclear and further studies are needed.