Objective To investigate the effects of olanzapine combined with metacognitive training on social cognition and insight of schizophrenic patients.Methods One hundred twenty patients with schizophrenia were randomly divided into two groups. All patients received four week treatment. The study gr oup received olanzapine combined metacognitive training treatment and the control group only used olanzapine treatment. The positive and negative symptoms scale (PANSS), the Insight and Treatment Attitude Questionnaire (ITAQ), the Beck Cognitive Insight Scale (BCIS) and Faux Pas Recognition Task (FPRT) were assessed at baseline and after four weeks of treatment. Result There was no statistically significant difference in the scores of all battery between two groups before treatment (P>0.05). the scores of total PANSS and subscales, ITAQ, BCIS and FPRT were statistically significant between study and control groups (P<0.05).After 4 weeks of treatment,the total PANSS scores and subscales scores were significantly lower in the study group than in the control group (P<0.05). The ITAQ score, self-reflection factor of BCIS, composite index and FPRT scores were significantly higher in the study group than in the control group (P<0.05). The difference in self-certainty of BCIS difference was not statistically significant(P>0.05).Differences of the remaining scales were statistically significant(P<0.05). Conclusion Olanzapine combined with metacognitive training has a significant effect on the social cognitive dysfunction in schizophrenic patients,improving the patient's insight and enhancing the social function.