Patients with schizophrenia show dysfunction in sustained attention and facial emotion processing. We investigated the interplay between sustained attention and emotion by presenting emotional faces as background during AX-CPT in patients with schizophrenia. Nineteen schizophrenia patients and 21 healthy control subjects participated. We presented AX-CPT number stimuli superimposed on the nose of background facial expressions (happy, neutral or sad) over three experimental blocks for each emotion. Signal detection sensitivity (A') and reaction time were measured. Patients showed a steeper sensitivity decline when happy faces (compared with sad faces) were presented as background stimuli. By contrast, controls' sensitivity was not affected by the background facial emotion stimuli. Across the emotion conditions, the decline of sensitivity over time was evident in patients, but not in controls. To our knowledge, the present study is the first to explore a change in sustained attention accompanied by simultaneous processing of emotional faces in schizophrenia patients. Our findings suggest that mechanisms underlying continuous performance test (CPT) performance decline over time and facial emotion deficit may interact with each other in patients with schizophrenia.