Four complementary approaches were used to investigate acetaminophen overdose as a risk factor for Parkinson's disease (PD). Circulating microRNAs (miRNAs) serum profiles from acetaminophen-overdosed patients were compared with patients with terminal PD, revealing four shared miRNAs. Similarities were found among molecular structures of dopamine (DA), acetaminophen, and two known PD inducers indicating affinity for dopaminergic transport. Potential interactions between acetaminophen and the human DA transporter were confirmed by molecular docking modeling and binding free energy calculations. Thus, it is plausible that acetaminophen is taken up by the dopaminergic transport system into the substantia nigra (SN). A ChEMBL query identified proteins that are similarly targeted by DA and acetaminophen. Here, we highlight CYP3A4, present in the SN, a predominant metabolizer of acetaminophen into its toxic metabolite N-acetyl-p-benzoquinone imine and shown to be regulated in PD. Overall, based on our results, we hypothesize that overdosing of acetaminophen is a potential risk factor for parkinsonism.Parkinson's disease (PD) affects about 0.5% of the population aged 60-69, 1% aged 70-79, and up to 2% aged above 80 years of age. 1 Familial mutations are responsible for ~ 10% of PD cases, leaving 90% sporadic cases for which causes are poorly understood. The toxicant 1-methyl-4-phenylpyridinium (MPP + ) is taken up by dopamine (DA) transporters (DATs) 2 and known to induce parkinsonism, which implies that exogenous factors may indeed induce PD. In addition, environmental toxicants, including pesticides (e.g., Paraquat), pollutants (metals and organochlorides), as well as dietary contaminants and drugs, such as methamphetamine (METH) have been suggested to cause sporadic PD. 3,4 Acetaminophen is a widely used analgesic/antipyretic agent. Although acetaminophen is relatively safe when used at therapeutic doses, acetaminophen poisonings are quite frequent. In fact, acetaminophen is responsible for >70,000 visits to the hospital and is responsible for around 300-400 deaths/year in the United States alone. 5 Acetaminophen toxicity is also a major issue in acetaminophen-opioid products, which led the US Food and Drug Administration (FDA) to limit the dose of acetaminophen in these combinations to 325 mg/ dose. 5 Hepatocellular injury due to formation of reactive metabolites is considered as a hallmark of acetaminophen toxicity. In rodent studies, acetaminophen has been shown to also cause damage to the brain, although it is not entirely clear