Objective To analyze the imaging characteristics of progressive supranuclear palsy （PSP）， and its correlation with clinical symptoms. Methods A total of 132 PSP patients treated at Tianjin Huanhu Hospital from October 2017 to October 2021 were selected as the PSP group， and 132 healthy individuals who underwent physical examinations at the same hospital during the same period were selected as the control group. All patients data were collected and analyzed， including general information， clinical manifestations， neurological examination results， cranial MRI， PET and other neuroimaging data. Results There was no significant difference between PSP group and healthy control group in gender， age and education level （all P ＞ 0.05）， but there was significant difference in the incidence of hummingbird disease （58.33% vs 0%）. 52 patients completed 18F-FDG PET examination， and the analysis showed that the metabolic rate of glucose in the frontal lobe， caudate nucleus， thalamus and midbrain of PSP patients was low； In patients with PSP， the glucose metabolic rate in the anterior cingulate cortex of vertical gaze palsy （VGP） decreased more significantly than that of not-VGP， and the glucose metabolic rate in the left temporal lobe， insular lobe， and anterior cingulate cortex of dementia group decreased more significantly than that of non dementia group （all P ＜ 0.05）. Conclusions Imaging is helpful for early diagnosis and differentiation of PSP， and clinical symptoms are related to glucose metabolism in specific brain regions.