IntroductionSchizophrenia can impair functioning and have serious individual and societal impact. Non-adherence rate to anti-psychotics is high due to side effects, raising the importance of adjuvant therapy. Artistic creation can help the patients expressing their illness experience and finding some order in their chaotic psychotic world.AimTo determine the differential effects of group art therapy on clinical symptoms and cognitive functions.MethodsPatients7 female patients symptomatically stable, non-substance abusing with chronic schizophrenia admitted into Mamoura Mental State Hospital in Alexandria, IQ level was determined by the Digit Span Test of Wechsler Adult Intelligence scale (WAIS) with the mean of IQ found = 89.InterventionTechniques taken from both art therapy and art expression provided as 24 group therapy sessions (2 sessions per week).Outcome measuresSymptoms severity measured by the Positive and Negative Symptom Scale (PANSS)Executive functions and set shifting measured by Wisconsin card sorting test (WCST)Visual attention and task switching measured by the Trail making testResultsPost treatment results showed significant decrease in PANSS sub-scales (positive p < 0.0001, negative p < 0.001, general p < 0.001, total p < 0.0001)Also significant increase in cognitive biases in WCST (number of categories) p < 0.05 and significant decrease in WCST (failure to maintain set) p < 0.01 and trail making B test (time spent p < 0.003 and number of errors p < 0.001)ConclusionSymptom severity and cognitive functions in stable schizophrenia can improve when art expression and therapy are provided.