Objective: To evaluate impact of risperidone long-acting injection (RLAI) versus oral antipsychotic treatments on hospitalization outcomes for patients participating in the electronic Schizophrenia Treatment Adherence Registry (e-STAR) in Spain. Methods: e-STAR is a two year, multi-national, prospective, observational study of patients with schizophrenia who were initiated on RLAI or an oral antipsychotic. This report is based on the final, complete e-STAR data from Spain. Hospitalization outcomes including number of hospitalizations and number of days in hospital were collected retrospectively for one year and prospectively every three months for two years. Changes in hospital stays and days in hospital were compared between RLAI patients and oral patients using a linear mixed model controlling for age, gender, disease duration, and baseline antipsychotic use patterns. Results: A total of 1622 patients (63.6% male, mean age 38.4±11.2 years) participated in e-STAR from Spain, 1345 were initiated on RLAI and 277 were treated with oral antipsychotics. RLAI patients had significantly longer disease duration (12.6±9.5 years vs. 10.9±9.7 in oral patients, p<0.01). Average hospital stay at baseline was five days longer for RLAI patients than oral patients. During the two year study, both treatments showed reductions in mean number of hospitalizations and mean number of days in hospital. As revealed by the mixed-model regression, RLAI patients, compared to oral patients, had a significantly greater reduction in mean number of hospitalizations (-0.28 vs. –0.18 in followup-year1 and –0.37 vs. –0.20 in followup-year2, p<0.05) and mean number of days in hospital (-17.23 vs. –12.96 in followup-year1 and –18.75 vs. –12.99 in followup-year2, p<0.01). Conclusion: This two year, prospective, observational study showed that compared to oral antipsychotics, RLAI treatment was associated with greater reduction in hospital stays and days in hospital in patients with schizophrenia.