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Aim: People presenting with first‐episode psychosis (FEP) can benefit from early intervention programmes. However, such programmes are scarce in low‐ and middle‐income countries (LMICs). In Brazil, there are a few programmes, but they are unequally distributed across the country. We aimed to describe the implementation and performance of the Ribeirão Preto Early Intervention in Psychosis Programme (Ribeirão Preto‐EIP), an outpatient service for patients presenting with FEP residing in the Ribeirão Preto catchment area in Southeastern Brazil. Methods: A detailed description of the service, staff and theoretical framework was compiled. Furthermore, a retrospective cohort study of patients attending the programme throughout 4 years (2015–2018) was conducted. Data were obtained by analysing the medical records of all patients, and sociodemographic and diagnostic stability information for this period was recorded. Results: The Ribeirão Preto‐EIP had 358 new referrals during the study period. Among them, 237 patients were assessed for an average (median) duration of 14 months. Most patients were male (64.1%) and single (84.8%). The median age was 23.5 years (range, 9–86 years). Schizophrenia was the main diagnosis (43.4%), followed by substance‐induced (25.7%) and affective (18.6%) psychosis. Referrals occurred from emergency, inpatient, community‐based mental health and primary care services. Conclusions: Programmes such as the Ribeirão Preto‐EIP demonstrate that early intervention in psychosis is feasible in LMICs despite significant challenges for their access and integration in the health system. Strategic scale‐up policies could be undertaken to offer better short‐ and long‐term outcomes for individuals presenting with FEP and their families. [ABSTRACT FROM AUTHOR]