It is estimated that over 120 million Americans suffer from moderate to severe attacks of migraine characterized by headache and other debilitating symptoms, resulting in impaired functional capacity and diminished quality of life. And, it appears, its prevalence is increasing. Since the prevalence peaks during the ages of 25-55, the prime working years, migraine places a tremendous burden on employers, primarily in the form of lost productivity as well as increased health benefits costs. The fact that migraine is underdiagnosed and undertreated suggests the existence of opportunities for interventions that will reduce that toll. This article focuses on the contributions that employee health units may make to such interventions. In addition to first aid for migraine attacks occurring during working hours, these interventions may include educating occupational health staff, managers, and line supervisors about the management of migraine; identifying migraineurs in the workforce; educating them about their problem and ensuring that they are receiving optimal care; controlling exposures to factors in the workplace that may trigger migraine attacks; and managing disability to minimize loss of productivity. Perhaps most important is encouraging migraineurs to be more aggressive in confronting this problem and empowering them to seek out personal physicians who will guide them to effective treatment and preventive regimens.