While the anxiety symptoms such as obsessive-compulsive (OC) and panic symptoms in schizophrenia have long been recognized, its underlying biological and clinical implications remain obscure. Prior to DSM-III-R, diagnostic conventions precluded simultaneously diagnosing schizophrenia and anxiety disorders. As a result obsessive-compulsive disorder (OCD) and panic disorder (PD) in schizophrenia were believed to occur only rarely and carry no significant clinical implications. However, recent epidemiological and clinical studies have shown much greater prevalence rates and significantly worse clinical course among the subgroup of schizophrenia with comorbid OCD and PD. Recent biological research suggest a distinct neurobiological basis and pharmacological treatment for these comorbid disorders. However, clinical management of schizophrenia with co-existing anxiety symptoms continue to challenge practicing clinicians. This subgroup of schizophrenia with co-existing anxiety symptoms may be conceptualized categorically, e.g., as reflecting presence of two distinct disorders, or dimensionally, e.g., as representing one of many phenomenological symptom dimensions in schizophrenia. While further studies are needed, evidence suggests that the schizophrenia patients with comorbid anxiety disorders would benefit from in-depth clinical evaluation and individualized treatment approach for optimal outcome. This symposium will examine the existing clinical, epidemiological, and neurobiological evidence and suggest a novel approaches for their clinical management.