INTRODUCTION: Behavioural symptoms, including hallucinations, apathy, and depression, are frequent in Parkinson's disease (PD). This review evaluated the effectiveness of rivastigmine in treating neuropsychiatric symptoms in PD. METHODS: A search of PubMed, MEDLINE and EBSCO (1 January 2000-1 October 2025) using terms related to PD and intervention (rivastigmine, anticholinesterase) was conducted. Case reports and case series were excluded. RESULTS: Eight studies (5 randomized controlled trials and three open-label studies) were selected. Due to the heterogeneity of the outcomes and methodological differences between studies, findings were summarized in a narrative way. In almost all studies, rivastigmine improved hallucinations. Data on the effect of apathy are mixed. CONCLUSIONS: The present review suggests that rivastigmine may improve hallucinations in selected PD patients. Future multicentre, adequately powered randomized controlled trials with a stratification by cognitive status, formulation, and dose of rivastigmine are needed. Despite the limited number of high-quality studies and methodological heterogeneity, clinical practice consistently suggests the beneficial role of rivastigmine in managing behavioural disturbances in PD. In real-world settings, rivastigmine is frequently associated with improvement of hallucinations and affective symptoms, particularly in individuals with co-occurring cognitive impairment. While these observations cannot substitute for robust controlled evidence, they provide additional support for the therapeutic value of rivastigmine.