Objective: Patients with Parkinson Disease (PD) are at increased risk of falls and those with cognitive impairment may be at even higher risk. This study examined cognitive performance in PD patients with and without a recent history of falls to better understand the relationship of cognition and falls in this population. Method: 131 patients (mean age = 61.94, SD = 9.99; mean education = 14.68, SD = 3.1; 85% Caucasian; 76% male) with advanced PD underwent neuropsychological evaluation as part of pre-surgical work up for deep brain stimulation surgery. According to chart review, subjects were grouped into categories (yes-no) based on their report of falls in the previous 6 months and compared on tasks of mental flexibility, processing speed, memory, language, attention, and visuospatial abilities. Results: 75 (57%) patients reported recent falls while 56 (43%) did not. Demographic variables did not differ between groups. Performances on cognitive measures ranged from low average to average for each group. The Recent Fall group performed significantly lower than the No Fall group on measures of visuospatial ability [Block Design: t(110) = 3.08, p = .003; Rey-Osterrieth Copy: t(114) = 2.05, p = .04], attention [Digit Span: t(125) = 2.55, p = .012], and mental flexibility [Trail Making Test B: t(123.63) = −2.37, p = .019]. Measures of simple processing speed, memory, and language did not significantly differ between groups. Conclusion(s): PD patients who reported recent falls had greater cognitive impairment than those without falls, particularly on measures of visuospatial abilities, attention, and mental flexibility. Examination of cognitive profiles in PD may help identify those at increased risk for falls.