OBJECTIVE: The frequency and nature of sustained remission of schizophrenia are controversial. METHOD: The authors assessed the prevalence of sustained remission among 155 middle-aged and elderly outpatients living independently. They compared patients with sustained remission to symptomatic schizophrenia patients and normal comparison subjects using standardized psychopathological, cognitive, and functional measures. RESULTS: Eight percent of the older schizophrenia patients living independently met criteria for sustained remission. Their level of psychopathology was similar to that in normal subjects and lower than that in symptomatic patients. On cognition, quality of well-being, and everyday functioning, the group with sustained remission was intermediate between the normal and symptomatic groups and differed significantly from the normal subjects. CONCLUSIONS: Sustained remission can occur even in older patients with very chronic illness, but its prevalence is lower than that in several published reports. Remission may reflect a return to premorbid functioning, consistent with neurodevelopmental hypotheses of schizophrenia.