Migraine represents a significant public health concern due to its widespread prevalence and the suffering it inflicts on individuals, leading to a substantial societal burden. Despite the availability of various potentially effective drugs, migraine often remains undiagnosed, and many patients do not receive adequate treatment. Given the diverse presentation of migraine among sufferers and even within the same individual across different periods, tailored treatment approaches are essential. Pharmacological therapy plays a crucial role in migraine management, encompassing symptomatic treatment for acute attacks and prophylaxis for prevention. This chapter focuses on discussing the main indications and goals of pharmacological therapy, including various drugs supported by scientific evidence and clinical experience. A brief overview of migraine treatment for pediatric patients will be provided in the following chapter.