Primary headaches, whose aetiologies cannot be identified by current diagnostic methods, represent the most frequent headaches and must be distinguished from secondary or symptomatic headaches, e.g. related to traumatic, vascular, inflammatory or neoplastic processes. Only an appropriate treatment will meet the expectations of patients, for who even a mild headache may generate important fears and handicaps. Medical history and physical examination form the basis for targeting the right diagnosis before any biological or radiological testing. The article presents guidelines implemented at the Geneva University Hospitals by the Pain Network of the institution. Therapeutic modalities and recommendations concerning the need for specialized assessments are presented to provide a framework in both emergency situation and long-term care.