The current study assesses neuromelanin sensitive MRI (NM-MRI) as a potential biomarker for treatment resistance (TR) in first episode schizophrenia patients. NM-MRI is a novel MRI sequence, which indirectly measures dopamine synthesis. Research using positron emission tomography (PET) imaging suggest that TR patients show lower dopamine synthesis than responders. We acquired NM-MRI in 61 first episodes schizophrenia patients. Treatment response was determined during 6 months follow-up. TR patients showed significantly lower NM-MRI signal compared to responders. These findings are in line with previous PET studies and demonstrate the potential of NM-MRI as alternative and more accessible biomarker for TR.