Parkinsonism is a common complication of neuroleptic drug use; however, the pathophysiology of the persistence of parkinsonian symptoms after withdrawal of neuroleptic drugs is poorly understood. Twenty patients with neuroleptic induced parkinsonism were studied by high field MRI. Persistence of symptoms was associated with different findings depending on the age of the patients--namely, putaminal hypointensity in young patients and striatal hyperintensities in old patients. High field MRI may be useful in identifying patients at higher risk for neuroleptic induced parkinsonism.