BACKGROUND: Parkinson's disease (PD) may influence postoperative recovery and discharge disposition following cervical spine surgery due to its effects on motor function, autonomic regulation, and systemic health. Therefore, we aimed to evaluate the impact of Parkinson's disease on clinical outcomes following primary cervical fusion, including readmission, complications, length of stay, costs, and discharge disposition. METHODS: Patients undergoing primary cervical fusion were identified from the Nationwide Readmissions Database (2016-2019) and underwent 1:1 propensity score matching based on demographic, comorbidity, and hospital characteristics. A total of 4,212 patients were included, evenly divided between those with and without Parkinson's disease (n = 2,106 each). Odds ratios were calculated to examine associations between Parkinson's disease and six outcomes: 90-day readmission, postoperative infection, posthemorrhagic anemia, non-routine discharge, top quartile hospital costs, and top quartile length of stay. RESULTS: Parkinson's disease was associated with increased odds of 90-day readmission (OR 1.17, 95% CI 1.02-1.35, p = 0.027), non-routine discharge (OR 1.42, 95% CI 1.25-1.60, p < 0. 01), and prolonged hospital stay (top quartile length of stay, OR 1.20, 95% CI 1.05-1.38, p < 0.01). No significant differences were observed in postoperative infection or posthemorrhagic anemia. A trend toward higher hospitalization costs was noted but did not reach statistical significance. CONCLUSION: Parkinson's disease is associated with higher rates of readmission, non-routine discharge, and prolonged hospitalization following primary cervical fusion. These results underscore the impact of Parkinson's disease-related neurologic vulnerability on postoperative recovery and highlight the need for coordinated perioperative and post-discharge care strategies in this population.