The pain of the migraine headache is often so debilitating that it severely compromises quality of life. The vascular component of the trigeminovascular system has been implicated in the pain mechanism. There is, however, debate as to whether the pain originates in the intracranial or extracranial vasculature or in both. In this article, evidence is presented to suggest that the extracranial arteries are the source of the pain in some migraine sufferers.