Factors that suppress natural killer (NK) cell activity were examined in a random sample of 73 schizophrenic patients. NK activity in these patients were compared with 25 healthy age, sex and race matched controls. The mean percent of NK activity was 21% in the schizophrenic group compared with 30% percent in the controls. The difference between these two groups was statistically significant. The mean percent of NK activity in the chronic undifferentiated schizophrenic subgroup and schizoaffective subgroup were 20% and 22% respectively. The degree of suppression of NK activity in the chronic undifferentiated subgroup was higher than in the schizoaffective one, but the difference was not statistically significant. The two subgroups were comparable regarding other immune related variables such as total white cell count, neutrophils, lymphocytes, total protein, albumin, globulin, immunoglobulins and stress. The lower impairment of NK activity in the schizoaffective subgroup may be due to their exposure to lithium which can enhance immune functions. Factors associated with significant suppression of NK activity in schizophrenic patients were physical restraint, number of psychotropic medications, number of chronic non-psychiatric diagnoses and race. Psychosocial stressors were associated with suppression of NK activity but it was not statistically significant. Our results identify factors associated with reduced NK activity observed in certain schizophrenic patients and NK activity in these patients may be the result of interaction between various factors.