Abstract Background Most studies with first episode psychosis patients have been conducted in high-income countries. On the other hand, very few first episode studies have been conducted in Latin-America. Therefore, the goal of our study is to determine predictors of treatment response, remission, relapse and rehospitalization in a first episode psychosis population from Medellin, Colombia. Methods Data was obtained from electronic health records from first episode patients with a diagnosis of schizophrenia-spectrum disorder diagnoses who were evaluated between January 2014 and December 2016 at two psychiatric institutions in Medellin, Colombia. Survival and Cox proportional hazard models were used for the analysis. Results Duration of untreated psychosis and hospitalization at the time of presentation was associated with both response and remission. Response was also predicted by less first-order symptoms and more years of education. Remission was predicted by older age of onset. Relapse and rehospitalization were predicted by use of substances and poor adherence to pharmacologic treatment. Less years of education and hospitalization at the time of presentation were also associated with rehospitalization. Conclusion Predictors of treatment response, remission, relapse and rehospitalization in first-episode patients are similar in Colombia compared to other high-income regions such as the United States and Europe.