Abstract: Objective To evaluate the efficacy and safty of Paliperidone in the treatment of schizophrenia mainly on the extrapyramidal symptoms （EPS） adverse reactions. Methods Conducted meta analysis of 17 literatures included Risperidone or Olanzapine for the control group by the RevMan4.2 software. Results In terms of efficacy, OR=1.36 95%CI（1.06,1.75）, P=0.02, the difference had statistically significance, which showed the efficacy of Paliperidone was significantly better than the control group. In terms of safety: Compared with the control group of Paliperidone, OR=0.49 95%CI（0.34,0.69）, P<0.000 1; compared with the control group of Olanzapine, OR=1.6495%CI（0.95,2.84）, P=0.08. The two results had statistical significance, which illustrated the situation of the EPS adverse reactions of Olanzapine was the best one, following with Paliperidone which ranked above the Risperidone’s. Conclusion By and large, the efficacy and safey of Paliperidone in the treatment of schizophrenia has certain advantages.