This course will address which migraineurs need prevention and why. Pharmacological treatment will be discussed, along with neuromodulating devices, supplements, and lifestyle interventions. Migraine treatment has evolved dramatically in the past 5 years and, because of this, migraine patients have experienced better outcomes with fewer side effects. It is important to look at what prevention outcome goals are and how to can track them. Even though older treatments were fraught with tolerability issues and patient compliance, it is important to understand them. Older therapeutic agents, clinical data, and how to utilize the information will be addressed. The rating system for migraine prevention medicines, formulated by scientific data, will be explored. In the past several years there have been changes to preventative migraine treatments, including botulinum toxin for chronic migraine and the advent of monoclonal antibodies to CGRP and GPANTS.