OBJECTIVES: Population-based data are sparse on utilization of prophylactic versus acute therapies in newly diagnosed migraine. We aimed to describe demographic and clinical characteristics of patients with migraine in Denmark according to initial migraine treatment.   METHODS: Using linked data on hospital diagnoses and outpatient dispensations of migraine-specific treatments (triptans, ergots, pizotifen, clonidine), we assembled a cohort of incident migraine patients aged ≥18 years, in Denmark, in 2005-2013. Date of the first hospital diagnosis or the second outpatient dispensation was the date of migraine diagnosis. We classified the initial migraine treatment as ‘no treatment’; ‘acute only’; ‘prophylactic only’; and ‘both acute and prophylactic’ and described the distributions of sex, age, comorbidities and comedications overall and by initial migraine treatment.   RESULTS:  We identified 114,308 patients with incident migraine (80% women, median age, 43 years (interquartile range, 34-53 years)). The initial migraine treatments received any time on/after migraine diagnosis date were as follows: acute only (N=85,729, 75.0%); prophylactic only (N=15,318, 13.4%); and both acute and prophylactic (8,753, 7.7%). 4,508 patients with migraine (3.9%) had no record of migraine treatment during the follow-up. Patients receiving prophylactic treatment only or both acute and prophylactic treatment were more likely to be women compared with those initially receiving acute treatment only (91% and 82% vs. 79%). Initiators of prophylactic treatment alone or in combination with acute treatment were also older (median age, 53 years and 51 years vs. 41 years), and more likely to have a history of diabetes (3.4% and 4.8% vs. 1.9%), hypertension (23% and 28% vs. 6.8%), or chronic obstructive pulmonary disease (14% and 18% vs. 11%). CONCLUSIONS:  For three-quarters of the patients newly diagnosed with migraine in Denmark, the initial migraine treatment was acute treatment only. Use of prophylactic medications was correlated with older age and higher comorbidity.