Aim of the study was to evaluate the cognitive and symptom predictors of outpatient service utilization in schizophrenia. The relationships between cognitive functioning (verbal learning and memory, executive functions), symptoms (positive symptoms, negative symptoms), and outpatient service utilization (case management, medication monitoring), were examined in 20 patients receiving outpatient services at a psychosocial clubhouse over a 12-month period. Executive functions, as measured on the Wisconsin Card Sorting Test (WCST), were the only significant predictor of outpatient service utilization, accounting for over 20% of the variance in total outpatient services used, with greater impairment associated with higher service utilization. Specifically, poorer performance on the WCST was associated with delivery of more case management services, but not medication management services. More case management services may be required to compensate for impairments in executive functioning in patients with schizophrenia.