Objective To analyze the disease burden of schizophrenia among young adults in China from 1990 to 2021, and predict its trends over the subsequent decade. Methods Using the 2021 Global Burden of Disease dataset, we selected the incident cases, prevalent cases, and disability-adjusted life years (DALYs) of schizophrenia among young adults aged 15–49 in China from 1990 to 2021. Joinpoint regression was applied to evaluate temporal trends via annual percent change and average annual percent change. The autoregressive integrated moving average model was used to forecast disease burden trends for the next decade. Results From 1990 to 2021, the total prevalent cases of schizophrenia among Chinese adults aged 15–49 years rose from 2.7872 million to 3.3243 million, while incident cases declined from 232 200 to 202 800. Meanwhile, DALYs attributable to schizophrenia increased from 1.8473 million person-years to 2.2031 million person-years. Compared with 1990, the 2021 standardized incidence rate (33.52/100 000 vs. 32.86/100 000), standardized prevalence rate (458.44/100 000 vs. 440.59/100 000), and standardized DALY rate (304.65/100 000 vs. 291.36/100 000) all increased. Joinpoint regression revealed significant increasing trends in the three standardized indicators, with average annual percent change of 0.07% [95% confidence interval (0.05, 0.09)], 0.14% [95% confidence interval (0.11, 0.16)], and 0.15% [95% confidence interval (0.13, 0.18)], respectively. The autoregressive integrated moving average model model projections suggested that by 2032, the incidence rate, prevalence rate and DALY rate would decrease to 29.29/100 000, 519.40/100 000 and 343.30/100 000 respectively, all remaining below the 2021 levels. Conclusions The disease burden of schizophrenia among young adults in China increased significantly from 1990 to 2021, with notable age and gender disparities. Forecasts indicate that by 2032, the incidence will keep decreasing, whereas prevalence and DALYs will continue to rise. Accordingly, schizophrenia prevention should shift focus from curbing new cases to long-term management of existing cases, and implement precise interventions based on population characteristics.