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With 17% to 18% of women suffering from migraine headaches, clinicians will often be asked by their patients to prescribe medication. Migraine is an episodic chronic disease that is best managed with an overall treatment plan, rather than treated as an acute illness that is managed with sporadic medications. Realistic goals for the long-term management of migraine are based on patient education and an ongoing discussion between patient and provider. This article reviews the clinical presentation of migraine and recommendations for both acute and preventive treatment, including complementary therapies. “Red flags” that could be signs of more serious neurologic illness are presented. The management of migraine in pregnancy is also reviewed.