Background: The association of olanzapine with hyperglycemia, an elevated lipid profile, and high blood pressure was early recognized after its approval and has become of increased concern. Objective: To determine the association of olanzapine use with blood sugar levels, lipid profiles, and blood pressure in hospitalized Iraqi patients with schizophrenia. Methods: A cross-sectional study involving 50 hospitalized patients with schizophrenia who met the Diagnostic and Statistical Manual of Mental Disorders (DSM)-V diagnostic criteria and had taken olanzapine for at least two years was carried out between November 2022 and February 2023 at two facilities in Baghdad, Iraq (Ibn Rushd Psychiatric Teaching Hospital and Al Rashad Hospital for Mental Health). Blood pressure, fasting blood sugar, and serum lipid profile (triglycerides [TG], high-density lipoprotein [HDL], low-density lipoprotein [LDL], and very-low-density lipoprotein [VLDL]) were measured at baseline and after olanzapine use. Results: Olanzapine significantly increases fasting blood glucose (P< 0.001). After using olanzapine, both systolic and diastolic blood pressures significantly increased. It significantly increased the levels of cholesterol, triglycerides, and VLDL (P<0.001). Moreover, HDL levels were drastically lowered. The current investigation found no significant link between the patient's waist circumference and current weight and the length of their illness or olanzapine use. In addition, there was no association between the duration of olanzapine use and blood sugar, blood pressure, or lipid profiles. Conclusion: Different doses and durations of olanzapine use in Iraqi schizophrenic patients are associated with a negative impact on glycemic control, blood pressure, and lipid profiles.