This case describes a growth hormone-prolactin, cosecreting pituitary microadenoma that presented with chronic, hyperandrogenic anovulation. A 37-year-old parous patient presented with 1 year of irregular cycles unresponsive to clomiphene citrate and a mildly elevated prolactin. Laboratory evaluation demonstrated hyperprolactinemia with an elevated, age-adjusted, insulin-like growth factor-1 level, and nonsuppressed growth hormone following glucose loading. Magnetic resonance imaging revealed a pituitary microadenoma, which was removed by trans-sphenoidal microsurgery. The diagnosis of acromegaly is often delayed because of the insidious progression and frequently subtle, early manifestations of this disease. In females, the second most common presenting symptom for acromegaly is irregular menses. This case confirmed the value of careful evaluation of patients who present with symptoms suggestive of polycystic ovary syndrome, especially if there are unusual signs or symptoms.