: Long-acting injectable antipsychotics (LAIs) represent a significant advancement in the treatment of schizophrenia (SCZ), particularly for improving adherence and long-term outcomes. This study aimed to assess the clinical outcomes of patients receiving atypical LAIs compared to those on various oral antipsychotics over a one-year follow-up in a naturalistic setting. : Sixty patients with SCZ were subdivided in two groups, those receiving LAIs ( = 25) and those receiving oral antipsychotics ( = 35). The groups were comparable for age, gender, educational attainment, employment status, marital status, smoking habits, and baseline SCZ severity, with no differences in baseline chlorpromazine equivalent dosages. : Over the follow-up period, patients in the LAI group discontinued treatment less frequently ( = 4.72, = 0.030), showed fewer suicide attempts ( = 5.63, = 0.018), fewer hospitalizations ( = 4.95, = 0.026), and fewer relapses ( = 6.61, = 0.010). Significant differences also emerged on the Drug Attitude Inventory (DAI-10) scores (F = 8.76, = 0.005) and Body Mass Index (BMI) values (F = 8.32, = 0.007), with the LAI group showing more favorable outcomes. : LAIs, compared to oral antipsychotics, may promote treatment adherence, as shown by decreased hospitalization; furthermore, their use is related with better outcomes, like fewer relapses and less suicide attempts in individuals with SCZ in real-world settings.