Although cognitive deficits have been recognized as core features of schizophrenia, their evolution over the course of the illness is still debated. This paper will report a literature review regarding neurocognitive changes in first-episode psychosis, the relationship with the duration of the untreated psychosis and the importance of early intervention strategies. The first episode of schizophrenia exhibits usually a clear cut off from the previous standard of the patient, but represents an opportunity due to the fact that the period of time between the onset of the illness and the prompt and person tailored beginning of treatment is an independent predictor of the evolution of the disorder. Early intervention and treatment are crucial to potentially achieving better clinical outcomes, and to alleviate the psychological impact on patients and their families.