The cause of dopamine cell death in Parkinson's disease remains unknown. Present interest centres on the possible involvement of a toxin mediated mechanism such as that produced, by MPTP. In post-mortem studies there is evidence in the substantia nigra for an on-going toxic process involving increased lipid peroxidation, altered iron metabolism and impairment of mitochondrial function at the level of complex I. Although the precise realtionship between these biochemical changes is not known, present evidence points to oxidative stress as an important factor contributing to neuronal loss. Altered mitochondrial function and increased iron levels may not initiate Parkinson's disease but rather act to accelerate cell death. Future strategies for the treatment of Parkinson's disease should be aimed at preventing oxidative stress and stopping or slowing the progression of the underlying pathology.