OBJECTIVES: We aimed to compare effect of atypical long-acting injection (LAI) with oral second generation agent (SGA) in Korean patients with schizophrenia based on real-world database. METHODS: Adult patients experienced recurrence between 2010 and 2013 were identified and divided into two groups, those who started using atypical LAI and those who continued oral SGA after the first recurrence. The both groups were matched using propensity score and were followed up to three years after the first prescription of atypical LAI after the first recurrence. Survival analysis was performed to compare the risk of the following recurrent in the LAI group to the oral group.   RESULTS: A total of 496 patients were matched among 16,484 schizophrenia experienced recurrence. The adjusted hazard ratio for the first recurrence during period was 0.96 (95% CI= 0.67-1.37, p=0.8135) for the LAI group compared to the oral group. The adjusted odds ratio for the medication adherence during follow-up period was 1.62 (95% CI= 1.07-2.46, p=0.0243) for the LAI group compared to the oral group. CONCLUSIONS: Among schizophrenia patients who had recurred, atypical LAI treatment had same effect for a prevention of the followed recurrence than oral SGA only treatment, but could improve medication adherence.