In some cultures, mental illness and its treatment may be closely linked to beliefs relating to sin, suffering, and separation from the divine, or even possession by evil. The aim of this study was to explore whether there was an association between receiving spiritual healing and the occurrence of schizophrenic relapses in a sample of elderly Egyptian patients. The method used was a case-control study, comparing patients with an ICD 10 diagnosis of schizophrenia who received spiritual healing and those without spiritual healing, in terms of the occurrence of relapses during a specified period. Patients who received spiritual healing relapsed more frequently than those who did not (adjusted OR 3.5 p < 0.05). Relapse was also associated with age and certain methods of healing. The risk of relapse was independent of gender, duration of illness and type of religion. The study found spiritual healing to be positively associated with relapse of schizophrenia in a sample of elderly Egyptian patients. It is however difficult to ascertain that the relapse actually started after the process of spiritual healing and not before it. The study findings may suggest that religious history, at least in some cases, should be taken into consideration when planning future management.