Objectives To investigate the value of transcranial color-code sonography (TCCS) in the diagnosis of Parkinson disease (PD). Methods Selected 52 cases of PD patients and 50 cases of healthy individuals, calculated the area of substantia nigra (SN) and hyperechogenic substantia nigra/midbrain (S/M). Results Hyperechogenic SN appeared in PD and control group in 41 (/52, 78.8%) and 19 (24.0%), respectively, they were statistical difference (X 2 = 4.766, P = 0.000). The area of hyperechogenic SN in PD group was 0.34±0.10 cm2 and the S/M was and 11±4% in PD group. However, the area of hyperechogenic SN in control group was 0.17±0.05 cm2 and the S/M was and 5±1% in control group. There was significantly statistical difference between two groups (t = 9.859, p = 0.000; t = 10.394, p = 0.000). According to receiver operating characteristic curve, using S/M = 6.5% and hyperechogenic SN = 0.215, the area under curve, sensitivity and specificity of TCCS in diagnosis of PD was 0.964, 98.1% and 84.6% and 0.929, 88.5% and 75.0%, respectively. Conclusion TCCS plays a very important role both in predicting the risk of PD in healthy individuals and in early diagnosing the PD.