To evaluate temporal changes in the geographic distribution of Parkinson''s disease (PD) mortality in the United States, we reviewed death rates for PD in the nine regions of the United States for 1980-1984. Age-adjusted mortality for all ages and for the elderly (65 years of age and older) was analyzed. Variation in PD mortality was observed among the regions for all demographic groups. The patterns were different from those reported during 1959–1961. Changing geographic patterns in mortality provide evidence for an environmental etiology for PD.