OBJECTIVES: It is common for patients with schizophrenia to exhibit symptoms of autism. Both autism spectrum disorders and schizophrenia share similar patterns of empathy deficits. This study purposed to explore the association between autistic features and empathy in Chinese patients with chronic schizophrenia. METHODS: We enrolled 857 patients with chronic schizophrenia. The Positive and Negative Syndrome Scale (PANSS), Repeatable Battery for the Assessment of Neuropsychological 7 Status (RBANS), and Interpersonal Reactivity Index (IRI) were employed to assess the participants' clinical symptoms, neurocognition, and empathy, respectively. The severity of autistic symptoms was assessed with the PANSS Autism Severity Scale (PAUSS), with PAUSS scores ≥ 30 were considered to have significant autistic features. RESULTS: 114 schizophrenia patients (13.3%) had autistic features. Compared to schizophrenia patients without autistic features, those with autistic features had more severe clinical symptoms, and poorer neurocognition and empathic abilities. Female sex and empathic concerns were independently associated with autistic features in patients with chronic schizophrenia. CONCLUSIONS: Our results suggest that autistic features tend to manifest quite commonly among patients with chronic schizophrenia. Empathy deficits are strongly associated with autistic features in patients with chronic schizophrenia, strengthening the view that autistic features may characterize a subgroup of schizophrenia patients.