Schizophrenia severely affects mental and physical health. Although 20-50% of patients experience significant improvement at some point in life, schizophrenia is the 5th leading cause of disability in men and the 6th in women; patients with schizophrenia die 12-15 years before the average population, and relatively few of them are in work. It is increasingly acknowledged that much of the personal, social and economic burden of schizophrenia is due to impaired functioning in the real-life of those affected. As a matter of fact, the focus of schizophrenia management has gradually shifted from reduction of symptoms and prevention of relapse to improved functioning in the real-life. The presentation will address the following issues: a) definition and measurement of schizophrenia outcome; b) main variables directly or indirectly influencing functioning in the real-life; c) unmet needs in schizophrenia present management; d) recent treatment strategies and e) priorities for research investments.