Objective: To investigate the effect of different frequency modified electroconvulsive therapy (MECT) combined with antipsychotics on the positive and negative symptom scale (PANSS) score and cognitive function of inpatients with schizophrenia. Methods: Ninety schizophrenic inpatients who met the inclusion criteria were randomly divided into treatment group A (n=30), treatment group B (n=30) and treatment group C (n=30). The treatment group A was treated with single antipsychotics, while the treatment groups B and C were treated with MECT combined with single antipsychotics. The frequency of MECT treatment was 1 and 2–3 times/week, respectively. After the observation of 8 weeks, PANSS score and MCCB score were compared between the three groups before and after treatment. Results: PANSS scores of group B and group C were significantly lower than those of group A after 4 and 8 weeks of treatment (P<0.05), PANSS score reduction rate and clinical total effective rate were higher than those in treatment group A (P<0.05), but there was no significant difference between group B and group C (P>0.05). After 8 weeks of treatment, the scores of 5 items of MCCB scale in group B and group C were significantly higher than those in group A (P<0.05), and the scores of “speech learning and memory” and “visual learning and memory” in group B were significantly higher than those in group C (P<0.05). Conclusion: Different frequency MECT combined with antipsychotics can effectively reduce PANSS score and improve cognitive function of patients with schizophrenia. The clinical efficacy is similar, but the effect of MECT once a week on improving early cognitive function of patients may be better.