Background Headache remains the most common cause of neurological consultation in clinical practice for which correct diagnosis and treatment are essential. Objective This article provides a review of headache presentation and management, with an emphasis on chronic headaches and the differentiation between migraine and tension-type headache (TTH). Discussion By far the most important diagnostic tool for proper headache diagnosis is the taking of a concise and representative history of the headaches. Migraine and TTH exist along a continuum and identification of the patient's position on this continuum has important implications for management.