Aim: To our knowledge; this is the first study that compared the efficacy and safety of aripiprazole 1-month and paliperidone 1-month and paliperidone 3-month long-acting forms preparations as well as plasma drug levels during the maintenance treatment of schizophrenia in the real world. Method: In our study, subjects were evaluated every month for four months with relevant psychiatric measures and plasma drug levels. Follow-up days were determined as days 0, 30, 60, and 90. Plasma drug levels of the treatments were analyzed by using LC/MS-MS. Results: No superiority was observed between the groups regarding PANSS positive and general psychopathology (p>0.05). It was observed that PANSS negative and total scores were statistically lower in the aripiprazole once-monthly group than in the paliperidone 3-month preparations (p<0.05). We observed that Quality of Life Scale interpersonal relations scores, the aripiprazole 1-month group exhibited higher scores than both of the paliperidone groups. Aripiprazole 1-month group scored higher than the paliperidone 1-month group in the intrapsychic foundations subscale (p<0.05). No significant difference was observed between extrapyramidal adverse effect, akathisia, and insight levels among the three groups (p>0.05). Aripiprazole 1- month group scored significantly lower than both paliperidone groups in the Arizona Sexual Experiences Scale (p<0.001). Aripiprazole metabolite was negatively correlated with depressive symptoms in the Calgary Depression Assessment Scale in Schizophrenia (p<0.05) and the Barnes Akathisia Rating Scale (p<0.05). Conclusion: Aripiprazole once-monthly showed superiority in efficacy aspects to PP3M but not PP1M and similar safety with both paliperidone formulations.