OBJECTIVE： To compare Paliperidone sustained-release tablet and Paliperidone palmitate injection in the treatment of schizophrenia in respects of medium-term and long-term efficacy， safety， insight， medication compliance and social function of patients， so ad to provide reference for drug selection in the clinic. METHODS： Eighty-four schizophrenia patients selected from our center during Mar. 2015-Jun. 2016 were divided into Paliperidone sustained-release tablet group （group H， 44 cases） and Paliperidone palmitate injection group （group Z， 40 cases）. Group H was given Paliperidone sustained-release tablet orally with initial dose of 3 mg/d， gradually increasing to 9 mg/d 2 weeks later according to disease condition； the drug dose was adjusted and ranged 3-12 mg/d according to disease condition. Group Z was given Paliperidone palmitate injection intramuscularly， 150 mg on 1st day， 100 mg on 8th day， and then given injection once a month， drug dose was adjusted according to disease condition （75， 100， 150 mg）. Treatment course of 2 groups lasted for 12 months. Before treatment， 1， 2， 3， 6， 9， 12 months after treatment， Positive and Negative Syndrome Scale （PANSS） was used to evaluate therapeutic efficacy； Scale to Assess Unawareness of Mental Disorder （SAUMD） was used to evaluate the cognition of patients to disease； Medication Adherence Rating Scale （MARS） was used to evaluate medication compliance； Personal and Social Performance Scale （PSP） was used to evaluate patient’s social function. The occurrence of ADR was observed during treatment. RESULTS： 3， 2 patients withdrew from group H， Z during treatment. Before treatment， there was no statistical significance in PANSS， SAUMD， MARS， PSP scores between 2 groups （P＞0.05）. 1， 2， 3， 6， 9， 12 months after treatment， PANSS and SAUMD scores of 2 groups were decreased significantly， while MARS and PSP scores were increased significantly， compared to before treatment， with statistical significance （P＜0.05）. 9， 12 months after treatment， PANSS and SAUMD scores of group Z were decreased significantly， while MARS and PSP scores were increased significantly， compared to group H， with statistical significance （P＜0.05）. There was no statistical significance in the occurrence of ADR between 2 groups （P＞0.05）. CONCLUSIONS： For schizophrenia， Paliperidone palmitate injection is better than Paliperidone sustained-release tablet in respects of medium-term and long-term efficacy， patient’s insight， medication compliance， social function recovery； the longer the time， the more prominent the superiority. There is no significant difference in safety between them.