To investigate the efficacy and side effects of quetiapine in refractory schizophrenia. The authors treated 40 patients with refractory schizophrenia with a single dose of quetiapine for 16 weeks. The efficacy and side effects were assessed by PANSS and TESS. The results showed that the PANSS total score and the three subscale scores decreased 4 weeks after treatment, i.e., there was a significant difference. 7 cases had a PANSS reduction rate of 50-79%, 19 cases had a PANSS reduction rate of 30-49%, and 14 cases had a PANSS reduction rate of 30%. The apparent efficiency was 17.5% and the effective rate was 65%. The effective dose was 400-600/day. The most common side effects were weight gain and postural hypotension. Conclusion: Quetiapine is safe and effective in the treatment of refractory schizophrenia and can be one of the drugs of choice. Discussion: Treatment of refractory schizophrenia is a difficult clinical problem in psychiatry. It has been suggested that 30-60% of patients with refractory schizophrenia are ineffective or only partially responsive to treatment. In the past 2 years, some psychiatrists have used Vestrone in combination with clozapine (or other antipsychotic drugs) for the treatment of refractory schizophrenia. The mechanism is to overcome the limitations of the two drugs alone, which may help those cases with poor or only partial response to single drug therapy. However, the side effects are also evident, and patients often discontinue treatment because they cannot tolerate it. Foreign literature reports that quetiapine is superior to traditional antipsychotics in refractory schizophrenia, and switching to quetiapine when treatment is ineffective may still provide efficiency. In this paper, by treating 40 cases of refractory schizophrenia with quetiapine, the overall effective rate was 65%. There was a significant difference in this study by a varying degree of score reduction after treatment with PANSS total score. It indicates that quetiapine has good efficacy in refractory schizophrenia with negative, positive symptoms. Quetiapine is a benzodiazepine derivative with a structure similar to that of clozapine, which has the function of blocking dopamine and 5-HT2 receptors, so it is effective for both negative, positive symptoms. In this study, quetiapine was found to have almost no extrapyramidal side effects, which may be related to the selective reduction of dopamine neuronal effects in the A10 region of the midbrain limbic system by quetiapine and the weaker effects on neurons in the A9 region of the substantia nigra, which is related to movement. Quetiapine has a weak sedative effect, and the most frequent side effects are weight gain, postural hypotension, and tachycardia. However, the manifestations are mild. Therefore, the cardiovascular effects are weaker and more appropriate for elderly and schizophrenic patients with cardiovascular disease. Due to the small sample size and short observation time in this paper, further studies on the long-term efficacy are needed in the future.