Parkinson’s superimposed syndrome is a degenerative disease of the central nervous system that manifests clinically with Parkinsonian-like symptoms, such as slow movements, limb tonicity, tremor, and gait abnormalities, while having features of other neurological pathologies, and includes a spectrum of diseases such as progressive supranuclear palsy, multisystem atrophy, corticobasal ganglion degeneration, and diffuse Lewy body disease. Parkinson’s superimposed syndrome often responds poorly to treatment with anti-Parkinsonian drugs. Progressive supranuclear palsy is characterized by supranuclear oculomotor disorders, dysarthria, pseudobulbar palsy, dystonia and postural abnormalities. Multi-system atrophy, also known as olivopontocerebellar degeneration, is divided into three main types, including P-type, C-type, and SDS, with P-type referring to Parkinson’s-like symptoms, C-type referring to cerebellar symptoms, and SDS referring to symptoms of vegetative impairment. The typical MRI manifestations are pontocerebellar and cerebellar midfoot cross signs. Corticobasal ganglia degeneration mainly starts with asymmetric limb movement symptoms with varying degrees of cognitive impairment and dementia during the course of the disease, mainly involving the frontoparietal cortex. Cranial MRI shows asymmetric frontal or frontoparietal atrophy. Diffuse Lewy body disease is characterized by fluctuating cognitive symptoms, visual hallucinations; limb tonicity and motor retardation, and pathology characterized by cortical Lewy inclusions. Parkinson’s superimposed syndrome is a group of diseases that include a combination of different pathologies, and although there are similarities in clinical symptoms, each has its own pathophysiology. A differential diagnosis should be made clinically, and then targeted treatment should be provided based on the diagnosis.