Migraine disorders are a common entity in women, especially during childbearing years. Fortunately, because of sustained elevated levels of estradiol in pregnancy, the incidence of migraine in pregnancy diminishes. Treatment options for pregnant women with migraines should begin with nonpharmacological remedies that promote a healthier lifestyle and address factors that provoke migraines. Triggers include alcohol, oral contraceptives, fasting, caffeine, and fatigue. Some women, however, will continue to have severe intractable headaches associated with symptoms such as nausea, vomiting, and possible dehydration. These symptoms not only disrupt the patient but also may become a risk to the developing fetus. The choice of which pharmacological method to use should not only be based on the severity of the migraine but should account for embryotoxicity, teratogenicity, fetal growth abnormalities, and perinatal effects. Pharmacological treatment includes acetaminophen, aspirin, nonsteroidal anti-inflammatory drugs (NSAIDs), opioid analgesics, antiemetics, and 5-HT 1 receptor agonists. Mild attacks may be managed with analgesics, whereas disabling ones usually respond to more specific drug therapy. Prophylactic treatment is rarely indicated in pregnancy and should be reserved for women with migraines that are long lasting, frequent, and unaffected by analgesics. Possible drugs that can be used in pregnancy include β-blockers, calcium channel blockers, amitriptyline, and NSAIDs.