The use of complementary and alternative medicine (CAM)- in migraine is a gr owing phenomenon about which little is known. This study was undertaken to evalu ate the rates, pattern and presence of predictors of CAM use in a clinical popul ation of patients with different migraine subtypes. Four hundred and eighty- on e migraineurs attending a headache clinic were asked to undergo a physician- ad ministered structured interview designed to gather information on CAM use. Past use of CAM therapies was reported by 31.4% of the patients surveyed, with 17.1 % having used CAM in the previous year. CAM therapies were perceived as benefi cial by 39.5% of the patients who had used them. A significantly higher propor tion of transformed migraine patients reported CAM treatments as ineffective com pared with patients suffering from episodic migraine (73.1% vs. 50.7% , P <.0 .001). The most common source of a recommendation of CAM was a friend or relativ e (52.7% ). In most cases, migraineurs’ recourse to CAM treatments was specif ically for their headache (89.3% ). Approximately 61% of CAM users had not in formed their medical doctors of their CAM use. The most common reason for decidi ng to try a CAM therapy was that it offered a ’ potential improvement of headac he’ (47.7% ). The greatest users of CAM treatments were: patients with a diag nosis of transformed migraine; those who had consulted a high number of speciali sts and reported a higher lifetime number of conventional medical visits; those with a comorbid psychiatric disorder; those with a high income; and those whose headache had been either misdiagnosed or not diagnosed at all. Our findings sugg est that headache clinic migraine patients, in their need of and quest for care, seek and explore both conventional and CAM approaches. Physicians should be mad e aware of this patient- driven change in the medical climate in order to preve nt misuse of healthcare resources and to be better equipped to meet patients’ needs. The use of complementary and alternative medicine (CAM) - in migraine is a gr owing phenomenon about which little is known. This study was undertaken to evaluate the rates, pattern and presence of predictors of CAM use in a clinical populization of patients with Four hundred and eighty-on e migraineurs attending a headache clinic were asked to undergo a physician- ad ministered structured interview designed to gather information on CAM use. Past use of CAM therapies was reported by 31.4% of the patients surveyed, with a 17.1% having used CAM in the previous year. CAM therapies were perceived as benefi cial by 39.5% of the patients who had used them. A significantly higher proposition of transformed migraine patients reported CAM treatments as ineffective com pared with patients suffering from episodic migraine (73.1% vs. 50.7%, P <.0 .001). The most common source of a recommendation of CAM was a friend or relativ e (52.7%). In most cases, migraineurs’ re course of CAM treatments was specifically for their headache (89.3%). Approximately 61% of CAM users had not in formed their medical doctors of their CAM use. The most common reason for decidi ng to try a CAM therapy was that it offered a The greatest users of CAM treatments were: patients with a diag nosis of transformed migraine; those who had consulted a high number of special sts and reported a higher lifetime number of conventional medical visits; those with a comorbid psychiatric disorder; those with high income; and those who headache had been either either misdiagnosed or not diagnosed at all. Our findings sugg est that headache clinic migraine patients, in their need of and quest for care, seek and explore both conventional and CAM approaches. Physicians should be mad e aware of this patient-driven change in the medical climate in order to preve nt misuse of healthcare resources and to be better equipped to meet patients’ needs.