The objective of this study was to evaluate the therapeutic effects of Chiglitazar combined with Rosa roxburghii Tratt (RRT) in inpatients diagnosed with psychiatric disorders and antipsychotic-induced metabolic syndrome (MetS).100 cases were included and divided into the Siglitazar group (n=50) and the Siglitazar + RRT group (n=50) Anthropometric measurements, lipid and glucose metabolism indicators, inflammatory markers and PANSS scores were assessed at baseline, 8 weeks and 12 weeks post-treatment. Both treatment groups exhibited significant reductions in waist circumference and improvements in lipid profiles and glucose metabolism indicators over the 12-week study period. The siglitazar + RRT group performed better in improving the lipid profile, with significant decreases in triglyceride (TG) and total cholesterol (TC) levels. Furthermore, levels of inflammatory markers (CRP, IL-6, TNF-α) decreased significantly in both groups, with consistently lower levels observed in the Chiglitazar + RRT group at 8 weeks and 12 weeks. Importantly, the Chiglitazar + RRT group exhibited a significantly lower PANSS score at 12 weeks compared to baseline, indicating improved psychiatric symptoms. Chiglitazar combined with RRT effectively improves metabolic parameters, reduces inflammation and ameliorates psychiatric symptoms in inpatients with antipsychotic-induced MetS.