With regard to aging of the general population non-neurologists are more frequently confronted with patients presenting with parkinsonian symptoms. The central task concerning treatment and prognosis in such cases is to differentiate idiopathic Parkinson's disease from secondary Parkinson syndromes and so called Parkinson-Plus-Syndromes. Besides clinical presentation neuroimaging techniques have been established in recent years, which can help with correct classification in early disease stages and difficult cases. In this article, we review the current clinical pathways for differential classification of parkinsonian symptoms with a special emphasis on clinical assessment and neuroimaging techniques like NMR and transcranial sonography.