OBJECTIVES: To review the consequences associated with schizophrenia relapse. METHODS: We searched the Medline, EBSCO and EMBASE up to February 2012 for eligible studies. Included studies were systematic reviews, meta-analyses, prospective observational studies, retrospective cohort studies or randomized controlled trials (RCTs) measuring the cost consequences of schizophrenia relapse or recurrence. The consequences from studies with different designs, countries and years were compared. RESULTS: Eleven studies conducted in Europe, United States, Germany, England, Australia, Japan and Brazil were identified and reviewed. Relapse in schizophrenia were characterized by higher rates of hospitalization, day hospital visit and psychiatric visit; longer inpatient days and more medications. Schizophrenia patients with relapse incurred significantly higher total annual direct medical costs, which were almost 2 to 4 times of those without relapse. The absolute annual cost of relapsed schizophrenia patients changed tremendously in different countries, approximately ranging from 1,198 USD (in 2006 USD) in Brazil to 50,986 USD (in 2000 USD) in the United States. The average cost of a relapse was 3421 EUR (in 2005 EUR). The driving part of the cost difference was attributed to inpatient care. Higher frequencies of reemergence of psychotic symptoms and aggravation of positive or negative symptoms were observed in these studies. Significant differences in patient quality of life in favor of patients without relapse were captured in some of the studies, while in other studies the differences were insignificant. The most frequently employed quality of life measurements were PANSS, CGI, GAF, Lehman QoL, EQ-5D, MLDL GI and SF-36. CONCLUSIONS: The findings of the review confirmed the significant economic burden of schizophrenia relapse, and showed such costs were mainly driven by more hospitalizations and longer duration of hospitalization. The cost consequence of relapse varies among countries. Relapse causes deterioration in patient quality of life as well.