High altitude airline travel can have various effects on health in normal subjects. The effect of airline long distance travelling at high altitude on Parkinson’s disease is not clearly known, and occasional reports suggest that after long-haul flights parkinsonian motor and aspects of nonmotor states may worsen temporarily. Worsening of parkinsonian state may be linked to air travel related dehydration, hypoxic effect of decreased oxyhaemoglobin saturation, jet lag, alteration in timing of drug intake as well as potential effect on sleep wake cycle and autonomic dysfunction causing syncope. Although symptoms are generally reversible, appropriate pre-travel planning, personalized to Parkinson’s disease subtype and disease, is essential to mitigate risks. Here, we provide an evidence-based overview of challenges and management strategies for Parkinson’s disease patients undertaking long-distance air travel.