Polycystic Ovary Syndrome (PCOS) may increase the risk for high blood glucose, infertility, depression, and overweight/obesity. Food insecurity or other nutrition and health factors may precipitate or result from PCOS. This study was designed to examine the relationship of household food security to fasting blood glucose, body mass index (BMI), produce intake, and depression in adult females with PCOS living in rural Appalachian Ohio. Females aged 18 years and older who attended a clinic for the care and management of PCOS were recruited by mailed invitation. A survey included questions from the U.S. Department of Agriculture household adult food security module, a depression scale, and a validated produce intake and behavior survey. Anthropometrics and biochemical indicators for blood glucose and lipid panel results were obtained from the clinics. Pearson’s r and Kendall’s Tau-b correlations were used to assess the relationship of household food security to other parameters. Participants (n = 54) were 32 ± 9 years and had a BMI of 34.5 ± 8.8kg/m2 (n = 39). Participants were primarily fully food secure and lived in households characterized by high household food security (n = 35, 64.8%). However, 19 (35.2%) participants were not fully food secure, and of these women, 7 (13.0%), 9 (16.7%), and 3 (5.6%) lived in households characterized by marginal, low, and very low household food security, respectively. According to the depression scale, 27 of 54 (50.0%) respondents had some degree of depression, with 18 (33.3%) having major depression. Daily vegetable, fruit, and total produce servings (n = 52) were 2.6 ± 1.8, 1.9 ± 0.9, 4.4 ± 2.3, respectively. For all participants with produce intake data (n = 52), 34 (65.4%), 37 (71.2%), and 36 (69.2%) met vegetable, fruit, and, total produce intake recommendations, respectively. Food insecure participants showed significantly higher rates of depression than the food secure participants (r = 0.466, p < .001). Lower food security was also associated with smoking (r = 0.285, p = .026), poorer daily vegetable intake (r = -0.337, p = .015), poorer total daily produce intake (r = -0.315, p = .023), lower perceived benefits of produce (r = -0.293, p = .032), lower predisposing domain score (r = -0.278, p = .042), and a smaller change in all domains (r = -0.280, p = .041). Additionally, the 7-item fruit and vegetable scores were significantly higher in food secure women (r = -0.297, p = .029). Other parameters were not significantly related to household food security. Overall, in females with PCOS, food insecurity was related to depression, smoking, and poorer produce intakes and behaviors. Further exploration is warranted in a larger sample to clarify these trends.