Lewy body disease (LBD) is one of the leading causes of neurodegenerative dementia in older adults and is characterized by a distinctive combination of cognitive, neuropsychiatric, and motor symptoms. According to the 2017 Dementia with Lewy Bodies Consortium criteria, diagnosis relies on the identification of core clinical features and supportive biomarkers, including dopaminergic imaging. Among these, spontaneous parkinsonism and reduced dopamine transporter (DAT) uptake on SPECT imaging are frequently but not invariably present or cooccuring in the clinical setting. Despite standardized diagnostic criteria, LBD remains underdiagnosed, particularly in Latin America where there is limited access to DAT-SPECT imaging. We conducted a cross-sectional observational study in a Neurologic Center in Buenos Aires, Patients diagnosed with LBD or prodromal LBD between 2020 and 2025 were included. All patients fulfilled criteria for probable or possible LBD according to the 2017 LBD Consortium guidelines. Core clinical features—cognitive fluctuations, visual hallucinations, parkinsonism, and rapid eye movement (REM) sleep behavior disorder (RBD)—were systematically assessed. Neurocognitive assessment included standardized measures of global cognition and specific cognitive domains. Dopaminergic imaging was obtained using 99Tc-TRODAT-1 SPECT . We aim to assess the relationship between clinical parkinsonism and DAT-SPECT findings. We aim to examine diagnostic conversion among abnormal DAT-SPECT patients