α-Synuclein (α-syn) is the most abundant protein found in Lewy bodies, a hallmark of Parkinson's disease (PD), and can aggregate to form toxic oligomers and fibrillar structures. Recent studies have shown that α-syn can be transmitted between neurons and can seed the formation of toxic aggregates in recipient neurons in a prion-like manner. In addition, it is known that Lewy body pathology may spread gradually and systematically from the peripheral or enteric nervous system or olfactory bulb to specific brain regions during progression of idiopathic PD. It is therefore conceivable that α-syn species could act as seeds that drive PD progression. Here, we review recent advances from studies of α-syn cell-to-cell transfer, the current understanding of α-syn toxicity, and how these relate to progression of PD pathology.