Polycystic ovary syndrome (PCOS) is frequently associated with metabolic disturbances and thyroid dysfunction, which may exacerbate hormonal and cardiometabolic abnormalities. This study aimed to evaluate the impact of thyroid functional status on metabolic and hormonal parameters in women with PCOS. A total of 100 women diagnosed with PCOS were enrolled and stratified into three groups according to thyroid function: euthyroid (normal TSH, (n = 55), subclinical hypothyroidism (n = 35), and overt hypothyroidism (n = 10). Anthropometric measurements, thyroid hormones, insulin resistance (HOMA-IR), and lipid profile parameters were assessed. Data were expressed as mean ± standard deviation, and group comparisons were performed using one-way ANOVA followed by post-hoc Tukeytest. Significant differences were observed among the three groups for all evaluated parameters. BMI and TSH levels increased progressively with worsening thyroid dysfunction (p < 0.001). Serum T3 and T4 levels decreased significantly across groups (p = 0.02 and p = 0.001, respectively). Insulin resistance was significantly higher in patients with hypothyroidism compared to euthyroid patients (p = 0.005). Moreover, triglycerides and LDL-C levels increased, while HDL-C levels decreased significantly with thyroid dysfunction (p < 0.05). Thyroid dysfunction, including subclinical hypothyroidism, is associated with adverse metabolic and hormonal alterations in women with PCOS. These findings highlight the importance of routine thyroid function assessment in PCOS patients to identify individuals at higher metabolic risk.