Objective To investigate the effects of drug treatment alone or drug combined with modified electroconvulsive therapy (MECT) on psychotic symptoms and cognitive function of patients with schizophrenia. Methods One hundred and four inpatients with first-episode schizophrenia were divided into the low age group (age 18-26 years, n=52) and high age group (age 39-46 years, n=52) according to their ages. Each group was further divided into the drug treatment group and drug combined with MECT group based on the therapeutic method. The positive and negative syndrome scale (PANSS) score and Wisconsin card sorting test (WCST) were used to assess the psychotic symptoms and cognitive function for patients of each group before treatment and after 3, 6, and 12 weeks of treatment. The results were statistically analyzed. Results The reduction of PANSS scores of the drug combined with MECT group of low age group were significantly higher than those of the drug treatment group after three weeks of treatment. The difference was statistically significant (P<0.001). The reduction of PANSS scores of the drug combined with MECT group of high age group were significantly higher than those of the drug treatment group after three weeks and six weeks of treatment. The difference was statistically significant (P<0.001). The number of responses and correct responses and completed categories of WCST of the drug combined with MECT group of low age group were significantly higher than those of the drug treatment group after three weeks of treatment. The number of continuous errors of the drug combined with MECT group of high age group was significantly lower than those of the drug treatment group. The differences were statistically significant (P<0.05). Conclusion The MECT can rapidly improve the psychotic symptoms and increase the cognitive function of patients of different ages.