Long-acting antipsychotic use in schizophrenia has become an advantage for treatment compliance and convenient administration of the drugs. There is no data on paliperidone palmitate (PP) use in pregnancy, which is the longest-acting (i.e., 1 month) atypical antipsychotic. In this case report, we aim to present a patient diagnosed with schizophrenia who had been using PP before and during her pregnancy until week 28 of gestation and gave birth to a male baby that weighed 3000 g at 39 weeks. As far as we know, this is the first case report on PP use during pregnancy.