Background and Aim: Schizophrenia is often accompanied by anxiety and difficulties in emotion regulation, which can exacerbate symptoms and impair social functioning. Virtual reality (VR) provides a safe and interactive environment that allows for gradual exposure to anxiety-provoking situations and the practice of adaptive emotion regulation strategies. This study aimed to examine the effectiveness of VR-based therapy in reducing anxiety and improving emotion regulation among patients with schizophrenia. Methods: This experimental study employed a pretest–posttest design with an active control group. The participants were 40 male (M= 38.52, SD= 9.05) inpatients diagnosed with schizophrenia at the Dar-ol-Shefa Rehabilitation Center in Ardabil, Iran. Eligible participants were purposively selected and randomly assigned to experimental and control groups. The experimental group received ten weekly 60-minute sessions of VR-based therapy, while the control group received treatment as usual. Data were collected using the Beck Anxiety Inventory and the Emotion Regulation Questionnaire administered at pretest and posttest. Results: Analysis of covariance indicated that VR-based therapy significantly reduced anxiety symptoms (p < 0.001) and improved components of emotion regulation (p < 0.001). Specifically, cognitive reappraisal scores increased, while emotion suppression scores decreased in the experimental group. Conclusion: These findings suggest that VR-based therapy can serve as an effective and innovative approach to reducing anxiety and enhancing emotion regulation skills among patients with schizophrenia, particularly in chronic inpatient populations.