This chapter provides psychiatrists with a synthesis of the latest evidence and clinical guidelines/guidance papers for the pharmacological treatment of negative symptoms of schizophrenia. Key definitions (e.g., primary vs. secondary negative symptoms) are reviewed in reference to companion chapters. A previous meta-analysis revealed a moderate placebo effect size (Cohen’s d = 0.64) in trials examining negative symptoms. This is greater than the effect size observed in most antipsychotic trials for treating acute schizophrenia. This finding underscores the difficulty of identifying treatment effects for negative symptoms. There are limited pharmacological treatment options for primary negative symptoms. The most compelling evidence has been provided by cariprazine and amisulpride. Management of secondary negative symptoms is discussed with respect to depression, extrapyramidal side effects, and comorbidities. A frequent but poorly understood association exists between negative symptoms and diabetes mellitus. Treatment-resistant schizophrenia frequently includes persistent negative symptoms; strategies such as clozapine augmentation with dopamine partial agonists are reviewed. The chapter underscores the importance of low-dose antipsychotic regimens, individualization of care, and addressing neglected factors (e.g., hyperprolactinemia, metabolic diseases) to improve outcomes in negative symptoms of schizophrenia.