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Abstract Background Progressive supranuclear palsy (PSP) and multiple system atrophy (MSA) are neurodegenerative disorders with distinct demographic and clinical profiles. In Middle Eastern countries, limited data exist on their demographic features and clinical manifestations. Objectives This study describes MSA and PSP patients in a Persian cross-sectional study. Methods This cross-sectional study was retrospectively conducted using medical records of patients diagnosed with MSA or PSP between January 2019 and January 2025, based on the MDS diagnostic criteria components at the initial diagnosis. Results A total of 106 MSA and 108 PSP patients were included. MSA-C (23.58%), MSA-P (60.37%), and unclassified (16.03%) were the subgroups of MSA in this project. PSP subtypes were PSP-P (72.22%), PSP-RS (26.85%), and PSP-PAGF (0.92%). The PSP group had a significantly higher age of participants in this study (71.82 ± 7.46 vs 68.85 ± 8.66). The male/female fraction was significantly higher in patients with PSP compared to the MSA group (70.37%/29.62% vs 45.28%/54.71%, p-value p-value
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