Headache is the most common condition to bring patients to healthcare providers worldwide. This is not only disabling to the patient but also causes direct as well as indirect financial burden to the family, as well as to the nation by reducing productivity. There is a significant disparity in resources between low to middle-income countries (LMIC) compared to high-income countries(HIC) for managing the headache despite the headache disorder occurring on a similar scale in both groups of countries. Identifying barriers is the most important step in improving access to preventive treatment. These barriers can be health-related, like inadequate training of healthcare providers or nonavailability of neurologists, drugs, or appropriate investigation. At the same time, there are political barriers like poor healthcare programs, resources, and minimal expenditure on health. The economic barriers, such as long-term medication requirements and the cost of investigations, are compounded by cultural barriers, including myths about headaches and scepticism about modern medicine. Finally, we proposed strategies for improving access to preventive treatment in LMICs. Tier 1, self-managed by the patients, which includes education on lifestyle measures, yoga, mindfulness and meditation for headache prevention. Tier 2, managed by a primary care physician with training about managing primary headache disorders and recognizing secondary headache disorders. Tier 3, managed by specialists/neurologists, includes chronic, refractory, rare primary headache disorders, and secondary headache disorders. We also endorse the development of local algorithms and management guidelines for headache treatment in LMICs.