Diffusional Kurtosis Imaging (DKI) and Magnetic Resonance Spectroscopy Imaging were employed to assess microstructural changes of hippocampus in patients with schizophrenia. Increased mean kurtosis and mean diffusivity were observed for both left and right hippocampi in patient compared to the control group. In patients, mean kurtosis showed a strong negative correlation with N-acetylaspartate concentration. These results suggest disorganized hippocampal microstructure, likely due to neuroinflammatory processes such as micro- and astrogliosis and/or disorganized neuronal domains. DKI’s apparent sensitivity to microstructural deficits may ultimately be employed to identify individuals with microscopic hippocampal impairment.