Abstract: Objective To investigate the effects of combining lurasidone with repeated transcranial magnetic stimulation （rTMS）on cognitive function,neurotrophic factors,and glucose and lipid metabolism in the treatment of schizophrenia. Methods 80 patients with schizophrenia admitted to the Seventh People’s Hospital of Wenzhou City from June 2021 to October 2023 were selected as study paricipants and conducted prospective analysis.They were randomly divided into a control group （n=40,treated with lurasidone alone）and an observation group （n=40,treated with lurasidone combined with rTMS） using a random number table method.The clinical efficacy,cognitive function improvement,and levels of neurotrophic factors and glucose and lipid metabolism were compared between the two groups. Results The overall effective rate of treatment in the observation group was higher than that in the control group（P＜0.05）.At 3 and 6 weeks after the treatment,the observation group showed higher Montreal cognitive state scale （MoCA） scores and lower positive and negative symptom scale （PANSS） scores （two-sided P＜0.05）.At 6 weeks after the treatment,the scores of the MiniMental State Scale （MMSE） in the observation group were significantly higher than those in the control group （two-sided P＜0.05）.The levels of neuron-specific enolase （NSE） in the observation group were significantly lower than those in the control group at 3 and 6 weeks after the treatment,while the levels of brain-derived neurotrophic factor （BDNF） and nerve growth factor （NGF） were higher at 6 weeks after the treatment （two-sided P＜0.05）.At 6 weeks after the treatment,the levels of glucose and lipid metabolism in the observation group were better than those in the control group （two-sided P＜0.05）.All the above indicators in both groups were better at 3 weeks after the treatment comparing to the baseline,and better at 6 weeks after the treatment comparing to 3 weeks after the treatment（two-sided P＜0.05）. Conclusion The combination of lurasidone and rTMS demonstrates significant efficacy in treating patients with schizophrenia,effectively improving cognitive function levels,regulating the levels of neurotrophic factors and glucose and lipid metabolism.