Background <p>Schizophrenia spectrum disorder is a major psychiatric condition characterized by cognitive deficits along with positive and negative symptoms. Iron deficiency has been shown to impact psychiatric symptoms via influencing the interaction between iron and dopamine. Our study was aimed to explore the association of iron status and negative symptoms in first episode schizophrenia spectrum disorder.</p> Materials and methods <p>This cross-sectional study was done on patients with the diagnosis of first episode schizophrenia spectrum disorder. Basic sociodemographic and clinical data were collected. We utilised Positive and Negative Scale (PANSS) and the Prominent Negative Symptom Scale from the Clinician Rated Dimensions of Psychosis Scale of the DSM-5 to determine the severity of symptoms. From blood, following parameters were collected: serum ferritin, iron, transferrin, total iron binding capacity levels (TIBC), hemoglobin, mean corpuscular volume and mean corpuscular hemoglobin levels.</p> Results <p>A total of 64 patients were included in this study, with a mean age of 31.59 ± 8.29, with a male predominance. The median duration of illness was 0.7&#xa0;years. Prominent negative symptoms were noted in 24 patients with significantly reduced serum ferritin, hemoglobin and increased TIBC and transferrin.</p> Conclusions <p>Our study has found a relationship between iron deficiency and negative symptoms, as lower serum ferritin was associated with negative symptoms. There is a possible role for iron as an adjuvant agent in treatment of negative symptoms therapeutically.</p>