OBJECTIVES:   Migraine affects 8% to 14% of the population in Western countries.  It affects primarily the young adult population and is responsible for many lost working days each year since it affects primarily the economically active sector of the community.  The primary aim of the study was to determine the prescribing patterns and cost of drugs for migraine in a primary care patient population.  METHODS:   A retrospective drug utilisation consumption study was conducted.  Data were obtained from a South African private health care group.  The database consisted of all central nervous system medicine for 2008.  RESULTS:   A total of 22102 patients (71.05% females) received 43144 items for migraine a cost of R3622552 (average cost of R83.96 per item).  The average age of patients was 44.90 (SD=13.83) years, with 70.76% of patients between 30 and 59 years of age.  The chi-square test was used to detect prescribing differences between female and male patients in different age groups (chi2 = 212.31;  d.f. = 6;  p <0.0001).  Differences were observed in prescribing to female and male patients.  Patients were prescribed an average of 1.95 items for migraine over the year.  The Lorenz curve was used to illustrate skewness in prescribing.  Clonidine was the most frequently prescribed active ingredient (46.15%), followed by cyclizine (29.62%).  The agents for the prophylaxis of migraine (clonidine, flunarizine and pizotifen) accounted for 50.48% of prescribing frequency and 29.04% of cost.  The selective 5HT1-receptor agonists (triptans) accounted for 18.94% of prescribing frequency and 53.54% of cost.  Rizatriptan was the most frequently prescribed triptan.  CONCLUSIONS:   The findings were generally in agreement with two other South African studies, although differences were observed.  A lower prescribing rate for triptans has been observed.  Qualitative studies on migraine are needed in South Africa to determine its impact on the quality of life of patients.