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Abstract Background Incidence of psychotic disorders is higher in many migrant groups; however little is known about internal migrants (IM). This study aims to describe the IR in natives (NA), IM and external migrants (EM). Method All patients aged 18–64 years, with First Episode Psychosis (FEP), who made contact with the Bologna West psychiatric services, between 2002 and 2010, were included. Results 187 cases were included. Age and sex adjusted IR of psychosis per 100,000 per year were: 12.6 for NA, 25.3 for IM and 21.4 for EM. The IRR was 1.93 (1.19–3.13, P = 0.007) for IM and 1.79 (1.06–3.02, P = 0.03) for EM compared to NA. Conclusion Rates of psychosis were significantly elevated in IM as well as in EM. This result adds evidence as to the role of migration itself (versus ethnicity) on the risk of psychosis.