The name PCOD is used when there is ultrasonographic evidence. The major task of an ultrasonographic examination is to rule out any space occupying mass. An ultrasonographic examination of the abdomen should be obtained. Modern techniques including ultrasonographic guidance and foam sclerotherapy are the latest developments in this evolution. Ultrasonographic examination can be performed to assess the extent of hepatic and spleen-related morbidity. Ultrasonographic findings will also guide the indication to biopsy and the long term follow-up.