Abstract: Objective To explore the role of intestinal flora in the pathogenesis of schizophrenia and its relationship with inflammatory factors. Methods Seventy cases of first episode schizophrenia were selected as schizophrenia group, and 70 cases of healthy subjects were selected as control group in Hangzhou seventh people hospital psychiatric from January, 2014 to December, 2016. The number of Bacteroides, Bacteroides and Bifidobacterium were determined by gradient dilution method. The levels of interleukin-2 (IL-2), interleukin-6 (IL-6), interleukin-10(IL-10) and tumor necrosis factor-α (TNF-α) were measured by enzyme-linked immunosorbent assay (ELISA). Results The number of bacillus in the schizophrenia group was higher than that in the control group (P<0.05). The number of bifidobacteria in the schizophrenia group was lower than that of the control group (P<0.05). There was no significant difference in the number of lactobacilli between the schizophrenia group and the control group (P>0.05). The Bifidobacterium/Bacteroides and Lactobacillus/Bacteroides in the schizophrenia group were lower than that in the control group (P<0.05). The levels of IL-2, IL-6, IL-10 and TNF-α in the schizophrenia group were higher than those in the control group (P<0.05). The levels of IL-2, IL-6, IL-10 and TNF-α in patients with schizophrenia were positively correlated with Pseudomonas aeruginosa (P<0.05). The Bifidobacterium was negatively correlated with serum IL-2, IL-6, IL-10 and TNF-α (P<0.05). Conclusion Patients with schizophrenia have intestinal flora imbalance and serum IL-2, IL-6, IL-10, TNF-α level increase. Intestinal flora and serum levels of inflammatory factors are closely related, Both may be involved in the pathogenesis of schizophrenia.