Purpose of Review <p>Cluster headache (CH) is a debilitating type of headache disorder, relatively rare and can be presented with atypical patterns. Aura is well determined in migraine patients, and recently it has been accepted to appear with other primary headache disorders, or even occurring in isolation. Hemiplegic Cluster Headache (HCH) is a rare variant of CH, defined and reported in patients presenting typical symptoms of CH along with reversible hemiparesis or hemiplegia, like reported in Migraine with Unilateral Motor Symptoms (MUMS). </p> Recent Findings <p>We identified eight published HCH cases with convergent clinical features and treatment responses based on the possible shared pathophysiology in HCH and hemiplegic migraine. We proposed diagnostic criteria in this review, based on literature findings.</p> Summary <p>HCH is rare but may be undiagnosed, aura features with concurrent motor unilateral weakness can be present due to associated comorbidity, motor aura, or in a secondary case. The proposed diagnostic criteria are useful for better recognizing the condition and afford improvement on treatment and future investigations.</p>