Review of geographical comparisons of the prevalence of schizophrenic disorders found a ten-fold range difference between geographical contiguous groups, with high and low prevalence pockets. We performed a 1-year prevalence study of schizophrenia in a limited area of Reunion Island in the Indian Ocean, and analysed the prevalence variability in contiguous regions of this area. We found one of the highest reported age-corrected (above 15 years) 1-year prevalence of schizophrenia (14.9 per thousand). Large discrepancies in the distribution of prevalence rates of schizophrenia were observed between the five towns analysed. Interestingly, when a higher prevalence was observed, it was highly correlated with an increase of the percentage of familial cases (r = 0.989, df = 3, P = 0.0014). Presence of founder effect often described in geographical isolates could explain the high prevalence rate and the heterogeneity between towns observed in our sample.