Impairments of verbal fluency are recognised in adult-onset schizophrenia but their presence in early-onset schizophrenia is not well established. This study investigated the extent and character of verbal fluency disturbance in young patients close to illness onset. Thirty-three adolescents with DSM-IV schizophrenia and 33 controls completed phonemic and semantic fluency tests and a free design fluency test. Patients had significantly impaired semantic fluency compared to controls but no impairment on phonemic or design fluency. The difference between patients and controls for semantic fluency remained significant when corrected for age and IQ. These results lend support to the hypothesis that impaired semantic fluency may be an early trait marker of schizophrenia that is potentially related to a failure of lateralisation of language.