Abstract: Objective To compare the differences of clinical features and imaging findings between vascular parkinsonism (VP) and idiopathic Parkinson’s disease (PD). Method The clinical features and imaging findings from 54 patients with VP and 53 patients with PD were compared. Results The main clinical manifestations of patients with VP were hemiplegia,rigidity and bulbar palsy with obviously pyramidal tract system damage and less rest tremor.Patients with PD showed remar-kable tremor-cogwheel rigidity.In the aspect of imageology,there were obvious imaging changes in patients with VP,mainly manifested lacunar infarction located in unilateral or bilateral basal ganglia and white matter of frontal lobe.Furthermore,some ischemic changes could be seen in the cerebral peduncle and lateral cerebral ventricle.In patients with PD,ischemic changes were invisible.As to the therapeutic effect to the anti-Parkinson’s disease,patients with PD showed better effect than VP patients. Conclusion As a self-sustaining clinical syndrome,the clinical manifestations and imaging findings in patients with VP are different from those with PD.