Background <p>Lumbar spinal degenerative and stenotic changes in Parkinson’s disease (PD) may contribute to limitations in physical activity, resulting in a worsened disease course. The pattern of lumbar spine degeneration and stenosis, the aim of the present study, remains largely unexplored.</p> Methods <p>This study included 82 people with PD (PwPD) and 98 age-matched control subjects (CS). Degenerative changes (disc and facet joint degeneration) and stenotic changes (foraminal and central canal stenosis) were assessed using established grading systems.</p> Results <p>Disk degeneration at all levels, facet joint degeneration at L3-L4 and foraminal stenotic changes mostly at L1-L4 and beneath L4 levels, were significantly correlated with PD progression (medium strength). PwPD exhibited significantly lower scores for facet joint degeneration and foraminal stenosis compared to CS; however, selecting the CS from subjects with potential lumbar pathologies limits the robustness of this conclusion. A significant positive correlation between the overall extent of degeneration and the total score of stenosis was observed in both groups. This positive correlation was represented in a regression model for both groups. The rate of degenerative and stenotic changes positively influences one another in a pattern of increasing rates, which was stronger in PwPD compared to CS.</p> Conclusions <p>Our findings indicate that PwPD may show lower levels of certain degenerative and stenotic changes; however, the interaction between these factors was more pronounced in these individuals compared to the controls. Future prospective studies can evaluate these findings and assess the role of PD scoring systems in lumbar MRI findings.</p>