Objective: To investigate the association of Parkinson disease ( PD) with education and occupations using a case- control study design. Methods: The authors used the medical records- linkage system of the Rochester Epidemiology Project to identify all subjects who developed PD in Olmsted County, MN, from 1976 through 1995. Each incident case was matched by age ( +/- 1 year) and sex to a general population control. The authors collected information about education and occupations using two independent sources of data: a review of the complete medical records in the system and a telephone interview. Occupations were coded using the 1980 Standard Occupational Classification. Results: Subjects with 9 or more years of education were at increased risk of PD ( OR = 2.0; 95% CI = 1.1 to 3.6; p = 0.02), and there was a trend of increasing risk with increasing education ( test for linear trend, p = 0.02; medical records data). Physicians were at significantly increased risk of PD using both sources of occupational data. By contrast, four occupational groups showed a significantly decreased risk of PD using one source of data: construction and extractive workers ( e. g., miners, oil well drillers), production workers ( e. g., machine operators, fabricators), metal workers, and engineers. These associations with increased or decreased risk did not change noticeably after adjustment for education. Conclusion: Subjects with higher education and physicians have an increased risk of Parkinson disease ( PD), while subjects with some occupations presumed to involve high physical activity have a decreased risk of PD.