Objective: In this study, we aimed to demonstrate the presence of liver fibrosis in patients with poly- cystic ovary syndrome at a relatively early stage of the disease using biochemical data and 2-dimen- sional shear wave elastography techniques. Methods: The study included 33 women with polycystic ovary syndrome and 33 healthy women volunteers. Serum androgen and sex hormone binding globulin levels were measured, and then free androgen index was calculated. Periostin and matrix metalloproteinase-3 levels were measured by ELISA method. Sterling formula was used to calculate FIB-4 score. Liver elasticity was evaluated using shear wave elastography. Results: Periostin and matrix metalloproteinase-3 levels were found to be significantly higher in the polycystic ovary syndrome group compared to the control group (P < .001 and P < .001, respectively). Serum testosterone level and free androgen index were also significantly higher in the polycystic ovary syndrome group (P = .044 and P = .037, respectively). However, there was no significant differ- ence between the groups in terms of liver velocity and elasticity (P = .185 and P = .172, respectively). A positive correlation was found between FIB-4 score and periostin (r = 0.433, P = .012) and between FIB-4 score and liver elasticity in the PCOS group (r = 0.374, P = .032). Conclusion: FIB-4 score was positively correlated with periostin and liver elasticity. These data sug- gest that in addition to FIB-4 score, serum periostin level and shear wave elastography may help us clinically in the detection of liver fibrosis at patients with polycystic ovary syndrome.