Abstract: OBJECTIVE To explore the effect of olanzapine combined with oxiracetam on cognitive dysfunction in elderly schizophrenics patients. METHODS The 60 elderly patients with schizophrenia and cognitive impairment admitted to a psychiatric hospital from August 2017 to March 2018 were randomly selected for prospective study, and were randomly divided into the olanzapine treatment group (single group) and olanzapine combined with oxiracetam treatment group (combination group), 30 cases in each group. The severity of the two groups of patients was evaluated by positive and negative symptom scale (PANSS) before the experiment, 4 weeks after the treatment, and 8 weeks after the treatment, respectively. The cognitive function was evaluated by Weiss digital span test (DS) and Wisconsin card classification test (WCST). Fasting blood was taken in the morning after 4 weeks, and liver function and lipid changes were monitored. Thirty healthy subjects aged 60 to 75 years old were recruited as the control group and evaluated above. RESULTS PANSS scores of the single group and the combination group were lower at 4 weeks than before treatment (P<0.05), and lower at 8 weeks than at 4 weeks after treatment (P<0.05). The scores of DS and WCST in the single group and the combination group were significantly improved 4 weeks after treatment (P<0.05), and the positive dorsal term and total score of DS and the correct response number of WCST were significantly higher in the combination group than in the single group (P<0.05). All DS scores of the two groups were significantly improved at 8 weeks of treatment compared with 4 weeks of treatment (P<0.05), and the number of correct response, wrong response and completed classification in WCST was significantly improved in the combination group compared with the single group (P<0.05). After 4 weeks, ALT, AST, TC and TG in both groups were higher than before treatment (P<0.05), but there was no significant difference between the two groups (P>0.05). CONCLUSION Olanzapine combined with oxiracetam can effectively improve cognitive dysfunction in elderly patients with schizophrenia, and the effect is better than that of olanzapine alone.