Abstract: Objective：To investigate the efficacy and safety of paliperidone combined with repetitive transcranial magnetic stimulation (rTMS) in the treatment of adolescents with schizophrenia. Methods：A total of 80 adolescent patients diagnosed with schizophrenia in Xijing Hospital, Air Force Military Medical University from March 2014 to May 2017 were selected. The patients were divided into study group and control group by random number table method, and 70 patients completed 4 weeks of treatment and follow-up. Patients in the study group received paliperidone and rTMS, and patients in the control group received paliperidone and sham stimulation. The duration of treatment was 4 weeks. Positive and negative syndrome scale (PANSS) analyses were performed before the treatment and after 2 and 4 weeks of the treatment. Results：The effective rate was 79.41% in the study group and 55.56% in the control group (P<0.05). The difference was statistically significant. There was no significant difference between the two groups in the PANSS scores of negative symptoms and general pathological symptoms after 2 and 4 weeks of the treatment. Statistically significant differences were found between the positive symptoms and total scores after 2 and 4 weeks of the treatment (P<0.05). There was no significant difference in the adverse reactions between the two groups. Conclusions：The rTMS could enhance the therapeutic effect of paliperidone in adolescents with schizophrenia, shorten the onset time, and improve the positive symptoms, without increasing adverse reactions.