The authors nonblindly assessed occipital cerebral asymmetry on computed tomography (CT) scans of 79 schizophrenic or schizoaffective patients and 100 neurological or medical patients. More of the schizophrenic patients had reversals of the normal asymmetry than did controls. The schizophrenics with CT evidence of brain atrophy has a higher frequency of normal asymmetrics than did controls, and the schizophrenics without atrophy had more reversed asymmetries. The schizophrenics with reversed asymmetry, compared with those with normal asymmetry, had lower verbal than performance IQ. Comparison of occipital asymmetry and lateral ventricular asymmetry indicated that reversed asymmetry in the schizophrenic patients was probably not due to localized atrophy.