Objective To investigate the effects of high-frequency repetitive transcranial magnetic stimulation(rTMS)combined with aerobic exercise training on motor function,walking ability and activity of daily living(ADL)in patients with mild to moderate Parkinson's disease(PD).Methods A total of 54 PD patients admitted in our department from March 2021 to January 2023 were recruited and randomly divided into conventional treatment group(n=27,aerobic exercise training for 2 weeks)and combination treatment group[n=27,aerobic exercise training plus high-frequency(10 Hz)rTMS in the bilateral primary motor cortex].Unified Parkinson's Disease Rating Scale-Ⅲ and ADL scale were applied in two groups before treatment(T0)and 1 h(T1)and 4 weeks(T2)after 2 weeks of treatment to compare the differences in motor score,gait pa-rameters(pace,stride length and stride frequency)and ADL score between them.Results At T1 and T2,the combination treatment group obtained significantly lower UPDRS-Ⅲ score(23.30±3.36 vs 26.22±4.04,24.04±3.45 vs 27.19±3.41,P＜0.01),but higher gait speed and longer stride length when compared with the conventional treatment group(P＜0.05,P＜0.01).In the combi-nation treatment group,the UPDRS-Ⅲ and ADL scores at T1 and T2 were decreased,stride speed and stride amplitude were increased when compared with the levels at T0(P＜0.05),and the ADL score was decreased at T1 than T2(P＜0.05).In the conventional treatment group,the UPDRS-Ⅲ and ADL scores at T1 were decreased than those at T0 and T2,and the step speed and stride length were increased at T1 than T0 and T2(P＜0.05).No statistical difference was found in step frequency between the two groups at different time points(P＞0.05).Conclusion High-frequency rTMS in the M1 area bilaterally combined with aerobic exercise training is superior to aerobic exercise training alone in improving PD motor symptoms and gait parameters(gait speed,and stride length),and its efficacy can last up to 4 weeks after treatment.