To compare the efficacy of dopaminergic (levodopa) and anticholinergic (benzhexol) medications in the treatment of tremor in patients with Parkinson’s disease (PD), and to evaluate the factors influencing response to these two medications in patients with resting tremor. Methods: A prospective study enrolled 141 patients with PD presenting with tremor, recruited at Beijing Tiantan Hospital between December 2021 and March 2024. On two consecutive mornings in a fasting state, participants underwent pharmacological challenge tests with levopoda and benzhexol. Resting, postural, intentional and kinetic tremors in patients with PD were evaluated using the Part III of the Unified Parkinson's Disease Rating Scale (UPDRS-III) and the Fahn-Tolosa-Marin Tremor Rating Scale (TRS). Tremor power across different contexts was analyzed via electromyography (EMG). The study compared improvement rates in tremor scale scores and absolute changes in tremor power following administration of each drug. Univariate and multiple linear regression analyses were employed to identify factors associated with drug response in resting tremor. Results: Levopoda outperformed benzohexol in improving all tested PD tremor types: resting (UPDRS-III P=0.003; TRS P=0.007), postural (TRS P<0.001), intentional (TRS P=0.002), and kinetic (TRS P<0.001). It also achieved greater reductions in tremor power during resting, resting + task, postural, and weight conditions (all P<0.05 v.s.benzohexol). Regression analyses indicated that better responses to levopoda for resting tremor were associated with higher rigidity-bradykinesia ( β =0.215, P=0.033) and anxiety scores ( β =0.211, P=0.015). Presence of dyskinesia enhanced response to levopoda ( β =0.300, P=0.001) but diminished response to benzohexol ( β =－0.357, P< 0.001). Worse responses to both drugs for resting tremor occurred in patients with higher kinetic tremor scores (levopoda β=－0.276, P=0.007; benzohexol β=－0.195, P=0.024). Conclusion: Dopaminergic medications are the preferred treatment for tremor in PD, particularly for patients with dyskinesia, and for those with severe bradykinesia, rigidity, and anxiety. The benefit of adding anticholinergic agents to treat dopamine-resistant resting tremor may be smaller in patients with pronounced kinetic tremor.