Despite a wealth of data generated by neuroimaging research in Parkinson disease (PD), no imaging techniques are currently recommended for routine clinical use. In this Review, Marios Politis assesses the various PET, single-photon emission CT, MRI and other imaging modalities that could aid the differential diagnosis and assessment of patients with PD. He then looks to the future of neuroimaging, including newly developed radioligands and combined-modality approaches, and discusses how research and clinical practice might better address the needs of patients.