The understanding of pathogenesis and treatment options for Migraines has evolved rapidly over the past two decades. Once thought to be exclusively a central nervous system disorder has now been better understood to include peripheral trigger sites. Treatment modalities have expanded to include excellent results with local anesthesia blocks, Botox injections, and release of peripheral nerve trigger sites. As the anatomic variations and physiology of migraine triggers become more clearly define we hope to be able to provide patients with more precise diagnosis and treatment options. This work serves to empower the many patients who suffer from migraines; and also to educate clinicians who desire a concise and evidence based resource on migraine history, pathophysiology, and treatment options.