OBJECTIVES: Schizophrenia is associated with extensive healthcare resource use which may relate to symptom type and severity. This study aims to quantify healthcare resource utilisation associated with different profiles of schizophrenia symptoms, based on data from the European Schizophrenia Cohort – a naturalistic two-year follow-up of 1,208 patients. METHODS: At each of the five semi-annual follow-up visits, patients were classed into eight health states based on the Lenert classification, accounting for symptom type (positive/negative/cognitive) and severity (mild/moderate/severe). We estimated consultations with general practitioner (GP), psychologist, psychiatrist and other specialists, day-clinic visits and the length of inpatient stay over six months preceding each visit, using a two-part statistical model based on two generalised mixed models. RESULTS: GP visits over 6 months ranged from 1.15 to 2.08, with highest burden linked to moderate positive and negative symptoms. Psychologist visits were the least frequently utilised resource type; highest use was estimated in patients who experienced moderate (0.50) or severe (0.44) predominantly negative symptoms, or severe positive and cognitive symptoms (0.51). All patients frequently visited their psychiatrist – with those experiencing mild symptoms requiring fewest visits (3.01) – but were far less likely to visit other specialists (probability 10–20%), with an average number of visits below 1.0 for all health states. Day clinic use varied widely between health states, both in terms of probability (2–14%) and the number of visits amongst those who did attend (7.9–91.7). Between 11% and 35% of patients required hospital admission, with patients experiencing extremely severe symptoms at highest risk. However, amongst those admitted, hospitalisation was generally prolonged regardless of health state (39–57 days). CONCLUSIONS: We quantified the substantial healthcare requirements of schizophrenia patients with different symptom characteristics, which is likely to assist future understanding of differences in resource utilisation of treatments along different health states in this disease.