<h3>Objective:</h3> To test the efficacy and sustainability of twice-weekly karate classes designed for individuals with mild to moderate Parkinson’s Disease (PD) on quality of life and individual goal attainment over six months and maintenance of karate practice at 12 months compared to individuals randomized to a waitlist. <h3>Background:</h3> Karate is a group-based martial art incorporating aerobic, strength, resistance, and mindfulness training, each of which individually confer benefits for individuals with PD. In our pilot of twice weekly, PD-specific karate classes (KICK OUT PD), we demonstrated high retention (79%), adherence (87%), and 18% improvement in quality of life over ten weeks, p = 0.01). To rigorously test these findings, we designed a six-month, randomized, waitlist-controlled trial. <h3>Design/Methods:</h3> We recruited and 1:1 randomized individuals with Hoehn & Yahr (HY) stages 1–3 PD to six months of twice weekly, 60-minute, no-cost, PD-specific karate classes or a waitlist control. We gathered baseline demographics, quality of life, and individual participation goals. We assessed adherence (% class attendance), quality of life, and goal attainment at six months. Finally, we assessed continued karate practice in the active group at 12 months. <h3>Results:</h3> We randomized 52 individuals (mean age: 65.7 years, 61.5% male, mean PD duration: 7.8 years, 88.5% HY 2). Mean attendance was 92.5% and active participants experienced a clinically significant improvement in quality of life (PDQ-8 within-group change: 24.2 vs. 15.0, p = 0.002) while the waitlist control group did not change (p = 0.12). Among active participants, 84% achieved their Individual goal and 63% continued karate classes of their own accord at 12 months. <h3>Conclusions:</h3> In this randomized, controlled trial, six months of karate for PD improved quality of life and was met with remarkable adherence and sustained 12-month participation. Future investigations into this promising exercise modality are indicated. <b>Disclosure:</b> The institution of Dr. Fleisher has received research support from Parkinson’s Foundation. The institution of Dr. Fleisher has received research support from NIH/NINDS. The institution of Dr. Fleisher has received research support from NIH/NINDS. The institution of Dr. Fleisher has received research support from NIH/NIA/Emory Roybal Center for Dementia Caregiving Mastery. Dr. Fleisher has received publishing royalties from a publication relating to health care. Dr. Fleisher has received personal compensation in the range of $0-$499 for serving as a Speaker with Parkinson’s Foundation. Dr. Fleisher has received personal compensation in the range of $500-$4,999 for serving as a Speaker with Lewy Body Dementia Association. Dr. Fleisher has received personal compensation in the range of $0-$499 for serving as a Speaker with Davis Phinney Foundation. Dr. Fleisher has a non-compensated relationship as a Editorial Board Member with AAN Brain & Life Magazine that is relevant to AAN interests or activities. Miss Woo has nothing to disclose. An immediate family member of Dr. Sennott has received personal compensation for serving as an employee of Abbott Laboratories. Joan O’Keefe has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Avexis, Inc. Dr. Gill has nothing to disclose. Dr. Anderson has nothing to disclose. Nicollette Purcell has nothing to disclose. Bichum Ouyang has nothing to disclose. The institution of Dr. Chodosh has received research support from NIH-NIA. The institution of Dr. Chodosh has received research support from NIH-NIMHD. The institution of Dr. Chodosh has received research support from NIH-NINR. The institution of Dr. Chodosh has received research support from SCAN Health Plan. The institution of Dr. Chodosh has received research support from New York State Department of Health.