Cognitive impairments are present in the majority of patients with schizophrenia, and the heterogeneity of symptoms and cognitive deficits represents a significant challenge in this field. Precisely defining cognitive profiles and distinguishing patients based on them could lead to greater clinical precision. Therefore, the aim of this study was to systematically review and critically analyze recent research on cognitive impairments and their characteristics in patients with schizophrenia, as well as to investigate their association with clinical symptoms, functional levels, and treatment response.The participant sample included adults diagnosed with schizophrenia, excluding those with schizotypal or unspecified psychotic disorders. Data were collected through searches of electronic databases (DOAJ, PubMed, Scopus, Web of Science) and analyzed using the PRISMA methodology. The findings revealed the presence of three to four cognitive profiles among the affected individuals, with the most common being globally impaired, selectively impaired, and preserved cognitive profiles. Patients with global impairments, compromised premorbid cognitive functioning, and treatment resistance exhibited the most pronounced negative symptoms and functional impairments, with all groups demonstrating significantly lower performance in processing speed and attention. Furthermore, recent cognitive-focused therapeutic interventions have shown efficacy in enhancing cognitive functions and reducing symptoms, particularly when combined with cognitive remediation and administered over an extended time period. It was concluded that cognitive impairments play a critical role in the functioning of patients with schizophrenia, and further research in this area is essential for the development of personalized therapeutic approaches and a deeper understanding of this complex disorder.