A debate held at the Movement Disorder Congress (MDS), 2021, discussed if clearing of α-synuclein aggregates is an adequate therapeutic strategy in Parkinson’s disease (PD). Alberto Espay, MD, FAAN, University of Cincinnati, Cincinnati, OH, argues against this, emphasizing that α-synuclein pathology represents a consequence of disease rather than a cause. Prof. Espay feels that the clearing of α-synuclein aggregates is not an adequate therapeutic strategy, since there is no relationship between Lewy pathology and clinical severity of PD or the level of degeneration. Therefore, the focus needs to be shifted towards the normal proteins that are lost rather than the abnormal aggregation. This interview took place during the 2021 International Congress of Parkinson’s Disease and Movement Disorders.