Abstract: Objective To investigate the clinical diagnostic value of pineal calcification(PC) in patients with first episode schizophrenia(FES). Methods The brain CT image of 220 cases who were diagnosed FES clinically were retrospective analyzed to observe whether the pineal has calcification and to measure its size.Meanwhile,compared with the healthy matched groups(n=200).Patients were divided into two subgroups according to the clinical classification:paranoia and non-paranoia group.After statistical treatment:①Analysis of the differences of PC between the patients and the controls.②The differences of PC between paranoia and non-paranoia group of FES.③The differences of PC between the gender of male and female in patients and groups.④The correlation between the size of the PC and the age of the patients. Results ①There were 139 cases (male 71,female 68) with PC in the FES patients,the incidence of PC was 63.18%(139/220).However,there were only 90 cases(male 41,female 49) of PC in the control groups,the incidence was 45%(90/200).The incidence of PC in FES patients was significantly higher than that in control group (χ²=13.97,P=0.001).②There was no significant difference in the incidence of PC between paranoia and non-paranoia group of FES(χ²=0.28,P=0.60).③There was no significant difference in the incidence of PC between the gender of male and female(χ²=0.88,P=0.35;χ²=0.25,P=0.62)④The size of PC in FES patients increased with the age before the age of 18,and was positively correlated(r=0.96,P<0.001).The pineal gland was calcificated earlier in FES patients compared with the controls. Conclusion The incidence of PC in FES patients was higher than that in the control groups,PC has a certain reference value for the early clinical diagnosis of FES.