〔Abstract〕 Objective To explore the clinical efficacy and safety of different regimens in the treatment of new-onset schizophrenia. Methods A total of 108 patients with newly diagnosed schizophrenia admitted to The Third People's Hospital of Zhaoqing city from February 2017 to April 2019 were randomly divided into group A, group B and group C, with 36 patients in each group. Group A received repetitive transcranial magnetic stimulation (rTMS), group B received rTMS combined with piperopilon hydrochloride, and group C received rTMS combined with Olanzapine. The curative effect, cognitive function changes and adverse reactions of the three groups were compared. Results There was no significant difference in the total effective rate between group B and group C (P > 0.05). The total effective rate of group B and C was higher than that of group A, and the difference was statistically signifi cant (P < 0.05). There was no signifi cant difference in Loewenstein scale score among the three groups before treatment (P > 0.05). After treatment, there was no signifi cant difference in Loewenstein scale score between group B and group C (P > 0.05). After treatment, Loewenstein scale score of group B and C was higher than that of group A, and the difference was statistically significant (P < 0.05). There was no significant difference in the incidence of adverse reactions between group B and GROUP C (P > 0.05). The incidence of adverse reactions in group B and C was lower than that in group A, with statistical significance (P < 0.05). Conclusion rTMS combined with antipsychotic drugs can improve the efficacy, improve cognitive function, reduce the occurrence of adverse reactions, and have high safety.