We studied the incidence of Parkinson's disease in 586 first-degree relatives (parents and siblings) of 114 randomly ascertained white patients with idiopathic Parkinson's disease and in 522 first-degree relatives of 114 age-matched unrelated white control subjects. Sixteen percent of patients had a family history as compared to 4% of control subjects (p < 0.01). The age-specific cumulative incidence was higher in the first-degree relatives of patients than in the first-degree relatives of control subjects (p = 0.007). The age-adjusted odds ratio was 3.5 (95% confidence interval: 1.3-9.4; p = 0.014). These results suggest that genes contribute to the etiology of Parkinson's disease.