OBJECTIVES: Examine the number of hospitalizations, emergency room (ER) visits, fractures, and falls among patients diagnosed with Parkinson Disease (PD) initiating therapy with either Selegiline (SEL) or Rasagiline (RAS). METHODS:  This study utilized data from the Truvan Health Analytics MarketScan Claims and Encounters Database from 1/1/2006 through 3/31/2011.  Eligible patients filled a prescription for SEL or RAS, with first such date identified as index date, were diagnosed with PD (ICD-9-CM 332 or 332.0) in the 2 years post the index date (i.e., the post-period), and were continuously insured from 6 months prior (i.e., the pre-period) through the end of the post-period.  Logistic regressions were utilized to estimate adjusted odds ratios of hospitalizations and ER visits (both total and PD-related) as well as odds of fractures and falls, while controlling for socio-demographic and clinical characteristics.  The apriori specified level of significance was 5%. RESULTS: There were 3,864 individuals in the analyses (1,085 SEL; 2,779 RAS).  On average, RAS patients were slightly younger (56.3 v 56.8 years; P=0.0320), had a significantly higher copayment associated with initial prescription ($44.72 v $21.36; P<0.0001) and were significantly more likely to have a comorbid diagnosis of high cholesterol (18.10% v 14.01%; P=0.0023).  After controlling for patient characteristics, general health, disability status, comorbid diagnoses, and index prescription characteristics, RAS was associated with significantly lower likelihood of all-cause hospitalizations in the post-period (OR=0.821; 95% CI= 0.682 – 0.988), all-cause ER visits (OR=0.791; CI =0.677 – 0.926), PD-related ER visits (OR=0.793; CI=0.643 – 0.979), and falls (OR=0.552; CI=0.335 – 0.909) compared to patients initiating with SEL.  There was not a significant difference between the cohorts in the odds of fracture or the odds of a PD-related hospitalization. CONCLUSIONS: Among patients with PD, initiation with RAS compared to SEL is associated with significantly fewer all-cause hospitalizations and ER visits and fewer falls.