Objective: The population over 60 years old is increasing in Mexico, and thus, the prevalence of chronic-degenerative diseases such as the Parkinson's Disease is increasing. The objective of this study was to compare the cost-utility of the treatment with pramipexol vs. the treatment with l-dopa/carbidopa and sustained release l-dopa/carbidopa, from an institutional perspective in Mexico. Methods: A cost-utility analysis was performed using a decision tree model that simulates the cost and Quality Adjusted Life Years (QALYs) for a hypothetical cohort of patients recently diagnosed with Parkinson's Disease, considering development or not of dyskinesias throughout a temporary horizon of four years. The utilities for each health state were obtained from reports in international literature. The model also considers changes in drug's dosage or the possibility that the patient received treatment with both drugs, according to the response and associated adverse events. Only annual costs per drug were considered for this analysis, as the rest of the costs are similar for buyers. Costs were estimated using 2006 prices and are expressed in US dollars (exchange rate of 10.9 pesos per US dollar). Results: It was estimated that a patient treated with pramipexol would have 3.07 QALYs on average vs. 1.96 QALYs for a patient treated with L-DOPA/carbidopa, and 1.98 QALYs for sustained release L-DOPA/carbidopa. Annual costs associated with each treatment are $1177.50 for pramipexol, $225.60 for L-DOPA/carbidopa and $449.90 for sustained release L-DOPA/carbidopa. The incremental cost per QALY gained was $3441.70 for pramipexol vs. l-dopa/carbidopa and $2649.8 for pramipexol compared with sustained release l-dopa/carbidopa. Conclusion: In Mexico, the treatment with pramipexol is a highly cost-effective alternative to manage Parkinson's disease considering the WHO cost-effectiveness threshold of 1GDP.