Pediatric migraine differs from adult migraine especially in regards to duration, localisation and quality of pain. A detailed description of the symptoms with a normal neurological examination allows in most cases to rule out secondary headaches without other exams. Many different medications are used for symptomatic or prophylactic treatment with success. Symptomatic headaches should be suspected if there is any abnormality in history or neurological exam. Headaches due to arterial hypertension, ENT problems or maxillofacial causes should not be forgotten. Intracranial hypertension should be excluded especially in children with ventriculo-peritoneal shunt, since shunt dysfunction can be fatal. Post traumatic headache can be impressive but have a good prognosis.