Background Non-ergot dopamine agonists (DA) are effective treatments for Parkinson's disease (PD). A review is presented of the pharmacology, evidence of efficacy and safety profile of pramipexole, ropinirole and rotigotine, and practical recommendations are given regarding their use in clinical practice. Results Extended release formulations of pramipexole and ropinirole and transdermal continuous delivery rotigotine patches are currently available; these may contribute to the stability of plasma levels and continuous dopaminergic stimulation. In early PD, the three of them significantly improved disability scales, delay time to dyskinesia and allow a later introduction of levodopa. In late PD they reduced total off-time, improved Unified Parkinson's Disease Rating Scale (UPDRS) in both on and off state and allowed a reduction in total levodopa dosage. Also, a significant improvement in quality of life scales has been demonstrated. Extended release formulations have proved to be non-inferior to the immediate release formulations, and even better tolerated (ropinirole). Despite a generally good safety profile, serious adverse events, such as impulse control disorder and sleep attacks need to be routinely monitored. Although combination therapy has not been addressed in scientific literature, certain combinations, such as apomorphine and another DA, may be helpful. Switching from a DA to another is feasible and safe, although in the first days an overlap of dopaminergic side effects may occur. When treatment with DA is stopped, dopamine withdrawal syndrome needs to be prevented. On suspension of a DA, especially pramipexole, the risk of producing apathy has to be considered. Conclusions New non-ergot DA are a valuable option for the treatment of both early and late PD. Despite a good safety profile, serious adverse effects may appear and need to be monitored. A pathoplastic effect on the course of the disease cannot be ruled out.