Objective: To evaluate and analyze the efficacy of olanzapine combined with risperidone in elderly patients with schizophrenia. Methods: A total of 168 elderly patients with schizophrenia treated in our hospital were selected. They were randomly divided into a single drug group and a combined drug group. The former was treated with olanzapine tablets, and the latter was treated with olanzapine tablets and risperidone tablets. The clinical symptoms and cognitive function of the 2 groups were analyzed and evaluated before and after treatment, and the clinical efficacy and the incidence of adverse reactions after treatment were counted. The levels of serum interleukin-6 (IL-6), IL-17 and tumor necrosis factor α (TNF-α) were detected by enzyme-linked immunosorbent assay. Results: After treatment, the Positive and Negative Syndrome Scale (PANSS) score of the combined drug group was significantly lower than that of the single drug group (P=0.0129). Compared with patients in the single drug group, the total effective rate of patients in the combined drug group was significantly improved (P=0.0399). There was no significant difference in the incidence of adverse reactions between the 2 groups (P>0.05). The levels of serum IL-6, IL-17 and TNF-α in the 2 groups before and after treatment were detected, and it was found that they decreased significantly after treatment, and the reduction range in the combined drug group was greater than that in the single drug group (all P<0.05). Conclusion: Olanzapine combined with risperidone in the treatment of elderly patients with schizophrenia can effectively improve their clinical symptoms and cognitive function, while improve the therapeutic effect without increasing drug side effects, and can reduce the inflammatory reaction of patients. The overall therapeutic effect is good.