Interpretation biases matching the concerns of a psychopathology have been implicated in the etiology of psychological disorders, but little research has investigated their presence in psychosis. Here we investigated negative, and specifically paranoia-relevant, interpretation biases in patients with schizophrenia, with (n = 32) and without (n = 29) paranoid symptoms and matched healthy controls (n = 29). Results revealed negatively biased interpretations of emotional ambiguity in both patient groups compared to controls—paranoid patients showing the stronger biases on material permitting paranoid interpretations than on other types of ambiguous material—but mixed evidence that this content-specific effect applied uniquely to the paranoid patient group. These data support models of psychopathology, including psychosis, which implicate cognitive biases in the formation and maintenance of core symptoms. We conclude that biased interpretation specifically related to paranoia deserves further detailed empirical investigation as a possible causal and maintaining factor for psychosis symptoms.