Background <p>Migraine surgery is a treatment option for selected patients with refractory migraines, targeting peripheral trigger points such as occipital, temporal, and frontal sites. This study aimed to assess the methodological rigor of available reviews using a Measurement Tool to Assess Systematic Reviews (AMSTAR 2) and to explore associations with publication characteristics, including citations, journal impact factor, year of publication, and PRISMA adherence.</p> Methods <p>A comprehensive search of PubMed, Scopus, and the Cochrane Library was performed to identify systematic reviews, with or without meta-analyses. Two authors independently screened studies and extracted data. Reviews were evaluated using the AMSTAR 2 tool, and adherence to PRISMA guidelines was recorded. Data extracted included journal, impact factor, publication year, country of corresponding author, number of included studies and patients, and main conclusions.</p> Results <p>Twenty systematic reviews were published between 2013 and 2026. Most focused-on outcomes evaluation of surgical intervention. According to AMSTAR-2, all the reviews were rated “Critically Low”, due to unmet critical domains, including lack of protocol registration, incomplete risk-of-bias assessment, and limited evaluation of publication bias. PRISMA adherence was reported in 80% of reviews, with more recent publications showing better compliance.</p> Conclusions <p>Despite generally positive findings regarding efficacy and safety, the low methodological quality of existing reviews limits the reliability of conclusions. Future systematic reviews should prioritize protocol registration, transparent reporting of excluded studies, comprehensive bias assessment, and standardized outcome measures. These improvements will help strengthen the evidence base and support clinical decision-making in migraine surgery.</p> Level of evidence <p>Not applicable.</p>