Objective To explore the characteristics of compliance with long-acting injections of paliperidone palmitate in community-dwelling schizophrenia patients under policy support. Methods The study population comprised schizophrenia patients who received paliperidone palmitate injections at designated hospitals under the long-acting medication policy in Baoshan District， Shanghai from August 2020 to December 2022. Through a one-year real-world follow-up， patients' general demographic information， clinical data， and treatment status with paliperidone palmitate were collected. Univariate analysis and multivariate Logistic regression analysis were employed to investigate factors influencing compliance with long-acting injections of paliperidone palmitate among community-dwelling schizophrenia patients. Results A total of 259 patients with schizophrenia were included in the study， with 5 lost to follow-up. Among patients receiving standardized treatment with paliperidone palmitate long-acting injection， 161（63.39%） maintained continuous treatment for one year（ compliance group）， while 93（36.61%） discontinued treatment（ discontinuation group）. Statistically significant differences were observed between compliance group and discontinuation group in terms of home supervision， self-awareness， social functioning， and number of oral medications（ all P ＜ 0.05）. Multivariate Logistic regression analysis indicated that weak home supervision［ OR=2.06，95%CI（ 1.03，4.15）］， lack of self-awareness［ OR=2.53，95%CI（ 1.03，6.23）］， and number of oral medications ≥ 4［ OR=3.85，95%CI （1.33，11.16）］ were risk factors for poor treatment compliance with paliperidone palmitate（ all P ＜ 0.05）. Conclusions Home supervision， self-awareness， and number of oral medications are factors associated with treatment compliance with paliperidone palmitate among community-dwelling schizophrenia patients.