Parkinson’s disease is produced by small strokes that affect the basal ganglia, not by neuronal loss in these regions of the brain. Compared with patients who have classical Parkinson’s disease, people with vascular parkinsonism tend to be older and are more likely to have lower body rigidity, difficulty walking, and disturbances of balance. Upper body tremor is relatively infrequent. A history of atherosclerotic vascular disease, diabetes mellitus, high blood pressure, or hyperlipidemia is common in vascular parkinsonism. Efforts to prevent vascular parkinsonism focus on the treatment of these predispositions.