This longitudinal, retrospective study evaluated epidemiology, pharmacologic management, resource utilization, and treatment costs (medications/consultations/diagnostic tests) for patients with episodic migraine (EM; <15-days/month, last 3 months) and chronic migraine (CM) in the UK, France, and Spain. The patient cohort, from a representative panel of electronic medical records, included adults with a record of migraine diagnosis or specific treatment from April 2016 to March 2017. Patients were stratified, with triptan usage as a surrogate for migraine, by migraine classification (EM/CM). Patients were followed for 1 year after first recorded migraine diagnosis or specific migraine treatment. This study included 42,439 patients in the UK (EM, 96%), 31,250 in France (EM, 88%), and 10,577 in Spain (EM, 82%). In the UK, France, and Spain, 15.7%, 10.1%, and 2.7% of all patients, respectively, received acute and preventive treatments. During follow-up, CM patients had more mean migraine-related consultations with general practitioners than EM patients in the UK (13.9 vs 4.6), Spain (15.0 vs 5.7), and France (4.2 vs 2.5); proportions with ≥1 migraine-related diagnostic test were higher for CM versus EM patients in the UK (12.1% vs 7.2%) and France (25.1% vs 18.7%), but not Spain (10.7% vs 9.8%). Mean quarterly treatment costs (payer’s perspective) were higher in CM versus EM patients in the UK (434.3€ vs 104.3€), France (155.7€ vs 40.8€), and Spain (986.8€ vs 111.5€). Migraine is associated with substantial healthcare and economic burden, with higher resource utilization and treatment costs among CM versus EM patients in the UK, France, and Spain.