Objective To investigate clinical efficacy and side effects of long-acting risperidone microsphere injection for treatment of patients with schizophrenia. Methods A total of 82 patients with schizophrenia were randomly divided into two groups,study group with long-acting risperidone microsphere injection and control group with atypical antipsychotics treatment for 24 weeks. The Positive and Negative Syndrome Scale (PANSS),The Personal and Social Performance (PSP) and Treatment Emergent Symptoms Scale (TESS) were used to evaluate efficacy and adverse effects of treatment at the end of 1st ,2nd,4th, 12nd and 24th week. Results The therapeutic efficacy in control group was similar to that in study group,and there was no significant difference between the two groups (P＞ 0.05 ). But the therapeutic efficacy in study group was better than that in control group at the end of the 4nd week (P＜0.05 ) , and study group was more likely to improve social function(P ＜ 0. 05 ). Incidence of adverse effects in study group was lower than that in control group , but the difference was not significant (P ＞0.05 ). The incidence of akathisia symptom in study group was higher than that in control group,but the difference was not significant (P＞0.05). The incidence of drowsiness symptom in study group was significantly lower than that in control group(P＜0.05 ). Conclusion Long-acting risperidone microsphere injection is as effective as atypical antipsychotics for treatment of patients with schizophrenia, but it has better efficacy in improving social function of the schizophrenia with lower side effects.