The main objective of this study is to assess the role of cavitation as a complementary therapy to weight reduction in women with Polycystic Ovarian Syndrome (PCOS) and abdominal obesity. Sixty Egyptian women with abdominal obesity and PCOS were randomly divided into two groups. Both groups consumed hypo- caloric diet and performed physical exercise for 6 months in aim to lose at least seven % of their body weight. In addition women in the second group underwent ultrasound fat cavitation to the abdomen once weekly. Total testosterone, fasting insulin, ovulation and regularity of menstrual cycles were assessed before and after treatment for both groups. The results showed that the participants in the second group had higher rates of regular menstrual cycles (83.3% vs 60%, P>0.05), higher rates of ovulation (76.6% vs 50%, P>0.05), lower levels of fasting insulin (12.4 ± 3.2 vs 15.3 ± 3.9, P>0.01) and lower serum total testosterone levels (46.8 ± 4.7 vs53.5 ± 5.4, P>0.001) compared to women in the first group. Ultrasound cavitation is considered as a safe and effective adjuvant to weight loss for Egyptian women with polycystic ovarian syndrome and abdominal obesity and it is associated with higher incidence of ovulation and regular menstrual cycles.