OBJECTIVES: Migraine is associated with significant medical costs in Western countries. However, there is currently limited information comparing the economic burden of different types of migraine including chronic migraine (CM) (≥15 headache days/month), especially in Asia. This study aims to estimate the medical costs associated with chronic migraine in Taiwan.  METHODS: A retrospective matched cohort study was conducted utilizing data from the Taiwan National Health Insurance Research Database. Cases of chronic migraine were defined as patients with ≥ one neurological outpatient visit with primary or secondary ICD-9-CM code of 346.11, diagnosed by neurologists in medical centers during 2007-2008. The 1st comparison group was other migraine sufferers (346.XX), without any migraine diagnosis before 2007, matched with cases at a 4:1 ratio by age, gender, and hospital setting. The 2nd comparison group was the general population without any migraine diagnosis during 2005-2009, matched with cases at a 4:1 ratio by age, gender, urbanization level of the residence and income. Medical costs within 365 days after the index date were assessed using a two-part model: a logistic regression to predict the probability of use of services and a generalized linear model to predict utilization for users of services. RESULTS: A total of 723 and 727 of CM patients were matched with 2384 of other migraine sufferers and 2906 of the general population, respectively. Patient with CM had significantly higher total medical costs versus those with other migraine (NT$52527 vs. NT$41886, difference=NT$10641; p<0.001) or the general population (NT$61018 vs. NT$21377, difference=NT$39641; p<0.001). The mean drug costs for CM sufferers were higher than those with other migraine (NT$16617 vs. NT$11217, difference=NT$5400; p<0.001) or the general population (NT$19691 vs. NT$7105, difference=NT$12586; p<0.001).  CONCLUSIONS:   Consistent with a higher burden of illness, CM sufferers in Taiwan had significantly higher medical costs than those with other migraine diagnoses or the general population.