Schizophrenia is an extremely rare condition in prepubertal children; psychotic symptoms in this age group need careful evaluation and may be due to many other disorders. Childhood onset schizophrenia, where children’s symptoms meet criteria for schizophrenia and where symptoms start before the age of 13, is a very rare disorder with a prevalence of less than 1/10,000 1. Childhood schizophrenia is essentially the same as schizophrenia in adults, but it occurs early in life and has a profound impact on a child’s behavior. Childhood schizophrenia includes hallucinations; delusions; irrational behavior and thinking; and problems carrying out routine daily tasks, such as bathing. With childhood schizophrenia, the early age of onset presents special challenges for diagnosis, treatment, educational needs, and emotional and social development. It is rarely reported less than 6 years of age in the literature. Here we present a 4.5 -year-old boy, who developed psychosis and discuss the clinical and familial features, diagnostic and treatment processes and 8 years follow-up of this particular case. He showed mild regression in speech, decrease in social relation, visual hallucinations (vision of spiders), smell hallucinations, aggression, lack of interest in toys, clapping his hands, swinging, seeing a penguin looking at him, seeing a man looking at him from wardrobe, talking to shadows, laughing idly. He was consulted to neurology department, all routine investigations and EEG results were normal.