This article reviews how to establish the diagnosis of migraine, the possible differential diagnoses, and the present state of the art of therapy. Emphasis is laid on nonsteroidal antiphlogistic drugs, serotonin receptor agonists (the so called triptans), and antiemetic drugs. The interval therapy consists of beta-blockers, calcium antagonists, antiepileptics, and serotonin receptor antagonists. The pathophysiology is based on the concept of sterile neurogenic inflammation, cortical spreading depression (CSD), and hyperexcitability of the central nervous system (CNS).