Aim of the study: Screening of idiopathic Parkinson's disease in first degree relatives in a sample of Egyptian patients by smell test and hyperechogenicity of substantia nigra and hypotrophy of vagus nerve. Methods: This is a cross-sectional observational study was done on forty-one Egyptian patients of idiopathic Parkinson disease and sixty of their first degree relatives collected from outpatient movement disorder clinic in Al Zahraa University Hospital and Kasr ELainy hospital from period February 2020 to November 2020. Demographic, clinical data, smell test, and transcranial sonography, and vagus nerve ultrasound of patients and their relatives were correlated to each other. Results: As regards 41 Parkinson patients: 25 (61.0%) have vagus nerve hypotrophy, 27 (65.9%) have substantia nigra hyperechogenicity, and 24 (58.5%) have hyposmia. As regard 60 relatives: 36 (60.0%) have vagus nerve hypotrophy , 26 (43.3%)have substantia nigra hyperechogenecity ,and 24 (40.0%) have hyposmia . There was no statistically significant difference (P > 0.05) found between patients and their relatives regarding vagus nerve caliber, and smell test while there was a statistically significant(P <0.05) difference between them regarding total substantia nigra hyperechogenicity. Conclusion: We found substantia nigra hyperechogenicity, vagus nerve hypotrophy, and hyposmia in first-degree relatives as well as that is seen in Parkinson patients.