Lack of insight and non-compliance in schizophrenic patients are often observed. The lack of insight is considered to be a primary symptom of disease. It is also common in first-episode schizophrenia. After the psychotic episode a trend to iprovement is seen, especially during the first year. Available data show that lack of insight is associated with cognitive dificit, non-compliance and insufficient social functioning. The possibilities to improve the lack of insight are scarce, psychoeducation and cognitive behavioral therapy are not very successful, positive effect can be rather observed with biological treatment. Non-compliance may be addressed by the right choice of antipsychotic drug and therapeutic alliance between the psychiatrists, patients and their relatives.