This study examined whether levels of emotional distress and impairments in visual memory were uniquely associated with severity of delusions in schizophrenia. Severity of delusions was assessed using select items from the positive component of the Positive and Negative Syndrome Scale among 44 persons with schizophrenia or schizoaffective disorder in a post-acute phase of illness. Emotional distress was assessed using the neuroticism subscale of the NEO Five Factor Inventory, and visual memory was assessed using the Rey Complex Figure Test. Controlling for executive function, visual attention, and verbal memory, a multiple regression analysis revealed that visual memory and neuroticism were each significantly related to severity of delusions, with the two combined accounting for one quarter of the variance. These same variables were unrelated to negative and excitement symptoms. Severity of delusions is linked to both higher levels of neuroticism and greater impairment in visual memory.