Atypical antipsychotics are commonly prescribed for the treatment of several psychiatric disorders including schizophrenia and psychosis. However prolong use leads to severe metabolic side effects such as weight gain, insulin resistance, impaired glucose tolerance, type 2 diabetes mellitus, dyslipidemia and essential hypertension. These metabolic abnormalities lead to an increased cardiovascular diseases.According to various studies the prevalence of antipsychotic related metabolic adverse reactions vary from 23 to 50% -two-three fold higher than general population.It is therefore necessary to find the underlying mechanism by which atypical antipsychotics cause metabolic toxicity. This book basically provides review encompassing schizophrenia, its underlying cause, atypical antipsychotic use and its role in causing metabolic toxicity. It also covers role of adipose tissue and adipocytokines in metabolic toxicity.This review should be useful for professionals in pharmaceutical industry and research students in Universities.