Polycystic ovary syndrome (PCOS), recently renamed Polyendocrine Metabolic Ovarian Syndrome (PMOS) (1) is a common endocrine disorder affecting women of reproductive age. Current international evidence-based guidelines promote lifestyle management, inclusive of diet and nutrition, as first-line treatment strategies (2). Accredited nutrition professionals, such as dietitians, are therefore well placed to deliver such support. Although dietary interventions for PMOS have previously been investigated (3), there is limited high-quality evidence favouring one specific dietary approach. Therefore, current evidence-based guidelines are consistent with general population recommendations, focusing on healthy lifestyle modification consistent with population based dietary guidelines (2). Despite these recommendations, there remains limited research exploring which nutritional approaches Australian dietitians are currently employing in practice to assist women with PMOS. Importantly, understanding the practice patterns of dietitians may aid in identifying important practice related gaps to inform and target future professional development opportunities in order to upskill the current and future workforce. We therefore aimed to investigate the barriers, facilitators and practice patterns of accredited dietetic professionals in the management of PMOS. We employed a mixed-methods cross-sectional analysis of Australian dietitians using a self-administered online survey to collect: self-rated knowledge and confidence levels for PMOS care; perceived barriers and facilitators to clinical management; awareness and implementation of evidence-based guidelines; and current dietary management practices. Quantitative and qualitative data were analysed in parallel, using both descriptive statistics and conventional content analysis. A total of n = 95 dietitians (37.9 ± 9.9 years) across a broad range of practice experience participated in the survey. Dietitians reported moderate levels of knowledge (n = 33; 38.4%) and confidence (n = 31; 36.5%) in the dietary management principles of PMOS. Perceived practice barriers included: supporting women through weight management, lack of interprofessional collaboration and dietary misinformation. Facilitators to clinical management included the availability of evidence-based dietary approaches, professional development opportunities and clinical knowledge and experience. Manipulation of macronutrients, dietary patterns, individualized medical nutrition therapy and lifestyle and eating behaviours were identified as key dietary management approaches for PMOS. A total of n = 44 (46.3%) respondents reported being familiar with evidence-based guidelines; however, of these respondents, one-quarter (n = 11; 25%) were able to identify the most recent iteration of the International Evidence-based Guidelines. Although many dietitians apply evidence-based dietary strategies and adapt interventions according to symptom presentation, the absence of a PMOS-specific framework limits the capacity to deliver comprehensive and consistent care. Addressing these gaps through the broader dissemination of guidelines, investment in targeted professional development and stronger interprofessional collaboration may enhance dietitians’ ability to provide patient-centred, evidence-based dietetic care in order to improve the health and wellbeing of women with PMOS.