A regular exercise regimen is important to maintaining a healthy lifestyle and is typically recommended as part of the biobehavioral management of migraine. Yet, patients may feel that strenuous activity could trigger their migraine and may choose to avoid being active to limit the likelihood of an attack. There is no standardized protocol that gives guidance to the amount or frequency that would improve migraine symptoms. In this chapter, the role of exercise and physical activity in migraine will be reviewed with suggested recommendations for patient management based on the evidence that exists.