PURPOSE: To evaluate memory impairment associated with electroconvulsive therapy (ECT)-antipsychotic (AP) combination in comparison to AP monotherapy in schizophrenia. DESIGN AND METHODS: A systematic literature search of randomized controlled trial (RCTs) was performed. FINDINGS: Eleven RCTs that compared ECT-AP combination (n = 508) with AP monotherapy (n = 510) were analyzed. ECT-AP combination was associated with greater impairment than AP monotherapy in (1) endpoint memory quotient (MQ) of the Wechsler Memory Scale (WMS)-Revised at the end of the ECT course; and (2) picture recall, counting, recognition, and associative learning of the WMS. However, no group difference was found in MQ at 1 and 2 weeks post-ECT. PRACTICE IMPLICATIONS: The ECT-AP combination was associated with greater transient memory impairment compared to AP monotherapy.