OBJECTIVES: Retrospectively assess the total costs of Parkinson Disease (PD) in Italy from a societal perspective. METHODS: We dispensed a questionnaire to PD patients divided in three sections: Economic (14 items) Quality of life (36 items) Care Giver Burdens (8 items. We included 268 patients with idiopathic PD, according to the CAPIT criteria. Those patients are representative of the population of 7500 movement disorder patients referring to our medical centre. The study population were divided in 3 groups accordingly to the classification of the Hoehn and Yahr staging scale. Costs of each group were assessed. The distribution of patients is spread on all the Italian territory. RESULTS: The mean annual direct cost of PD is 5639.12€. Drug therapy counts for 32.8 % of total cost (1849€), rehabilitation for 19.44 % (1.096€), inpatient hospital care for 19.61 % (1105.83€), “out of pocket” patient expenses (private visits, paid rehabilitation, home care) count for 18.53 % (1,044.93€), Specialist and Gp visit for 5.92 % (333.84€). As the severity of the disease grows the PD costs turns form National Health System to patient “out of pocket” expenses. Costs are significantly higher when patient suffers from motor fluctuations. QoL reduces dramatically as the PD symptoms worsen. CONCLUSIONS: This study shows that PD represents a relevant monetary burden for the society associated to a significant worsen of QoL. The total cost of this disease, based on an estimation of 160.000 idiopathic PD patients in Italy, is about € 76,000,000 per year. Moreover, due to the demographic tendency in our country we can assume an increase of this value in the coming years.