Introduction: Amenorrhea, the absence of menstrual periods, is a common gynecological condition with diverse etiological factors, including endocrine disorders, genetic conditions, and lifestyle influences. This study aims to evaluate the underlying causes of amenorrhea in a cohort of women presenting with this condition, focusing on identifying the most prevalent etiological factors and their clinical implications. Material and Methods: A total of 250 women aged 15-45 years with primary or secondary amenorrhea were included in the study. Inclusion criteria comprised women with no menstrual periods for at least three months (secondary amenorrhea) or no menstruation by age 16 (primary amenorrhea). Exclusion criteria included pregnancy, known hormonal disorders, or recent use of hormonal contraceptives. A comprehensive evaluation, including medical history, physical examination, hormonal assays (FSH, LH, prolactin, TSH, estradiol), and pelvic ultrasound, was conducted to identify the etiological factors. Results: The study revealed that polycystic ovary syndrome (PCOS) was the most common cause of amenorrhea (35%), followed by hypothalamic amenorrhea (25%), hyperprolactinemia (15%), and primary ovarian insufficiency (10%). Other causes accounted for 15% of cases. Laboratory findings showed elevated FSH levels in 40% of patients, while imaging studies identified polycystic ovaries in 35% of cases. Conclusion: This study highlights the diverse etiological factors contributing to amenorrhea, with PCOS being the predominant cause. A systematic diagnostic approach, including hormonal and imaging evaluations, is essential for accurate diagnosis and effective management. Early identification of the underlying cause can significantly improve patient outcomes and guide targeted therapeutic interventions.