Case reports of co-existent Parkinson's disease (PD) and hemifacial spasm (HFS) suggest that there may be a relationship between these conditions. Three of 300 (1%) PD patients presented with HFS compared with 0/300 (0%) controls. The mean age of the three PD patients with HFS was 68.7 ± 8.0 (60–76) years, with the majority having left-sided HFS. All three patients developed HFS symptoms at around the onset of PD and they were significantly older than the 100 patients with HFS alone (P < 0.05). Our study demonstrated no significant increased risk of HFS amongst the general PD population and hence HFS symptoms are unlikely to be of clinical importance for most PD patients.