This clinical prospective study was done at the ultrasonography unit of 6 October Insurance Hospital. The aim of this work was to evaluate the association between Acanthosis Nigricans (AN) and Hyperinsulinetnia (HI), Hyperandrogenemia, obesity and the presence of Polycystic ovarian disease PCOD. The study was done on 35 females at childbearing period, all of them were having AN plus 20 control females with negative diagnosis of AN. Every control and patient subject was evaluated for the presence of HI, obesity, hyperandrogenemia, and the presence of PCOD by clinical examination, hormonal assay for FSH, LH & Testosterone level. Pelvic ultrasound was done for every one of them to evaluate the presence of PCOD. In the (AN) group, 57.1% were having hyperinsulinemia compared to not a single case in the control group, 42.2% showed signs of PCOD compared to 5% in the control group, 85.7% of the patients group were obese compared to 20% in the control group. 74.3% of the (AN) group showed signs of hyperandrogenemia with not a single case in the controls. In the 20 patients with AN and HI, 13 (65%) patients showed signs of PCOD, 17(85%) patients showed signs of obesity, and 16(80%) patients showed signs of hyperandrogenemia. From these findings we can conclude that there is positive correlation between hyperinsulinemia, obesity, PCOD and Acanthosis Nigricans. Also AN could be a warning sign for the presence of PCOD.