Background: Auditory verbal hallucinations (AVH) are considered a significant diagnostic positive symptom that is experienced by ~70% of schizophrenia spectrum disorders. Up to 25% of AVHs are resistant to treatment; also, depression and suicide are common with auditory hallucinations. Therefore, future research should be done to clarify the pathology of these hallucinations to help in more effective treatment. Recent perfusion studies have investigated regional cerebral blood flow (rCBF) in brain areas, especially those generating AVH. The study aims to evaluate CBF alterations of brain regions in schizophrenic patients with AVH and without AVH compared with healthy control individuals using MRI using the pseudocontinuous arterial spin labeling technique. This study highlights that there is statistically significant higher rCBF in schizophrenic patients in the AVH group) compared with the schizophrenic non-AVH group in the following areas: right parietal, right superior temporal gyrus, left caudate, right lateral prefrontal, right insular cortex, right putamen, right temporal, and left temporal. However, there is statistically significant lower regional CBF in schizophrenic patients in (AVH) group in comparison with schizophrenic non-AVH group in the left parietal, left lateral prefrontal, right caudate, and left midcingulate cortex. Also, there is statistically significant higher regional CBF in the schizophrenic patients in the AVH group compared with the control group in the following areas: right parietal, right superior temporal gyrus, right caudate, right lateral prefrontal, right putamen, right temporal, and left midcingulate cortex. However, there is statistically significant lower regional CBF in schizophrenic patients in the AVH group in comparison with the control group in the following areas: bilateral occipital, left parietal, left lateral prefrontal, left caudate, bilateral insular, right anterior cingulate cortex, left putamen, and left temporal. There are significant changes in rCBF, which discriminate schizophrenic patients in the AVH group from other groups schizophrenic patients without AVH group and control group. Potential implications: exploring the path physiology of the brain underlying auditory hallucinations will open new horizons for treating auditory hallucinations in different approaches such as neurosurgery and transcranial magnetic stimulation to achieve a new perspective for the diagnosis and treatment of psychotic disorders.).