Background According to most relevant guidelines, family psycho-educational interventions are considered to be one the most effective psychosocial treatments for people with schizophrenia. The main outcome measure in controlled and randomized studies has been prevention of relapses and admissions, and encouragement of compliance, although some questions remain about its applicability and results in clinical practice. Objectives The aim of study was to evaluate the efficacy and implementation of a single family psychoeducational intervention in 'real' conditions for people diagnosed with schizophrenia. Methods A total of 88 families were randomized in two groups. The family intervention group received a 12 months psychoeducational treatment, and the other group followed normal standard treatment. Assessments were made at baseline, at 12 and at 18 months. The main outcome measure was hospitalization, and secondary outcome measures were clinical condition (BPRS-E) and social disability (DAS-II). Results A total of 71 patients finished the study (34 family intervention group and 37 control group). Patients who received family intervention reduced the risk of hospitalization by 40% (P =.4018; 95% CI: 0.1833-0.6204). Symptomatology improved significantly at 12 months (P =.4018; 95% CI: 0.1833-0.6204), but not at 18 months (P =.4018; 95% CI: 0.1833-0.6204). Social disability was significantly reduced in the family intervention group at 12 months and 18 months. Conclusions Family psychoeducational intervention reduces hospitalization risk and improves clinical condition and social functioning of people with schizophrenia.