The pathological mechanism of schizophrenia remain unclear. More than 30% of schizophrenic patients become treatment refractory schizophrenia due to poor curative effect， even after adequate and effective treatment. It results in significant disease burden. This article reviews the current treatment， neuropathological mechanism， potential therapeutic targets and curative effect prediction of refractory schizophrenia， hoping to provide reference for the pathological mechanism research and treatment of refractory schizophrenia.