The neuropathology of parkinsonism is reviewed as it occurs in primary (idiopathic) and secondary extrapyramidal syndromes. Present understanding of the significance of Lewy bodies in Parkinson's disease, diffuse Lewy body disease, and Lewy body variant of Alzheimer's disease is emphasized. The neuropathology produced by a variety of secondary causes is also considered to demonstrate the diverse lesions that can result in parkinsonism.