We reported a case of infection of pneumatized crista galli presented with frontal headache having similar features suggestive of tension type headache. Although it may be an extremely rare cause of frontal headache, we reviewed reported literatures focusing on the frontal sinus pathologies affecting pneumatized crista galli. This case highlights that both the primary and secondary headache disorders may cause headache in the frontal region, and therefore need to be considered in the differential diagnosis.