OBJECTIVES: Prenatal testosterone is known to influence both cerebral laterality and 2nd to 4th digit ratio (2D : 4D). Epigenetic changes are thought to play some role in it. We studied sex-related differences between 2D : 4D and cerebral laterality in patients with schizophrenia and controls to examine the effects of prenatal testosterone in the development of schizophrenia. METHODS: Forty one men (18 schizophrenic patients and 23 controls) and 40 women (17 schizophrenic patients and 23 controls) were recruited from one psychiatric hospital in Korea. The 2D : 4D and electroencephalographic (EEG) coherence in 19 channels (66 pairs of interhemispheric coherence and 54 pairs of intrahemispheric coherence) were measured. The sex-related statistical analyses between 2D : 4D and EEG coherence in controls and patients with schizophrenia were performed using multiple regression. RESULTS: In male patients, the relationship between 2D : 4D and right intrahemispheric EEG coherence showed mainly positive correlation in delta and theta frequency bands, while it showed negative correlation in male controls. In female patients, the relationship between 2D : 4D and interhemispheric EEG coherence showed stronger positive correlation in alpha and beta frequency bands, while it showed weaker positive correlation in female controls. CONCLUSIONS: Low prenatal testosterone may play certain roles in altered correlation between 2D : 4D and cerebral laterality in schizophrenia and the development of schizophrenia by epigenetic mechanism.