Schizophrenia is a complex, heterogeneous disorder for which an accurate diagnosis is critical to the provision of appropriate information and treatment recommendations to individuals and their family members. The symptoms of schizophrenia cannot be linked to a specific pathophysiological mechanism, and thus must be assessed based on observations, verbal reports, and inferences. Thus, patient self-report is central to making a diagnosis. However, individuals with schizophrenia can have difficulty describing their experiences. This difficulty may be due to the direct effects of symptoms but can also be compounded by poor insight and cognitive impairment. Additionally, high rates of substance use, mood symptoms, and traumatic experiences in this population can complicate self-reporting and the differentiation of schizophrenia symptoms from these other factors. In this chapter, we will describe these challenges and offer strategies to address them in the context of diagnostic interviews. We outline procedures for gathering information, discuss the impact of race, culture, diversity, and age; summarize diagnostic criteria, and provide tips for “dos and don’ts” of conducting diagnostic interviews with individuals with schizophrenia.