To observe metabolite ratio changes in cingulate gyrus of schizophrenia patients with auditory hallucinations using 1 H-MRS. Methods: According to the P3 item score of the PANSS, 30 schizophrenic patients were divided into non-auditory hallucination (NAH) group (P3≤3) and auditory hallucination (AH) group (P3>3) with 15 patients in each. And 15 healthy subjects were enrolled as control group. The N-acetylaspartic acid (NAA)/[choline complex (CHO) + creatine (CR)], NAA/Cr, NAA/CHO, and Cho/Cr ratio in the cingulate gyrus in the 3 groups were compared by 1H-MRS scanning. The correlation between the metabolite ratios in the cingulate gyrus of schizophrenia patients experiencing auditory hallucinations and the course of disease, age of onset, and auditory hallucinations score was analyzed. Results: NAA/(CHO+CR), NAA/Cr, and NAA/Cho in the AH group were significantly lower than those in the control group (P<0.05) and NAH group (P<0.05); furthermore, the indexes in the NAH group were all lower than those in the control group (P<0.05). There was no significant difference in CHO/Cr among the three groups (P>0.05). NAA/(CHO + CR) and NAA /Cr ratios in the cingulate gyrus were significantly correlated with auditory hallucination score (P<0.05), and the CHO/Cr ratio was not correlated with auditory hallucination score (P> 0.05). NAA/(CHO+CR), NAA/Cr, and NAA/Cho were not correlated with age of onset and course of disease (P>0.05). CHO/Cr was correlated with age at onset (P<0.05) but not with course of disease and auditory hallucination score (P>0.05). Conclusion: Schizophrenia patients with auditory hallucinations have significant metabolic changes in the cingulate gyrus. The cingulate gyrus may serve as a link in the conductive pathway involved in the pathogenesis of auditory hallucination.