OBJECTIVES: To examine the health care resource utilizations and costs among migraine patients in the U.S. Medicaid population. METHODS: Migraine patients were identified (International Classification of Disease, 9^th Revision, Clinical Modification [ICD-9-CM] diagnosis code 346) using Medicaid data from January 01, 2009 through December 31, 2009. The first diagnosis date was designated as the index date, and patients were required to have at least a 1-year baseline (pre-index date) and 1-year follow-up (post-index date) period. A comparison cohort was created for patients without a migraine diagnosis during the study period, using 1:1 propensity score matching to control for age, region, gender and baseline Charlson Comorbidity Index score. The comparison cohort’s index date was chosen at random to minimize selection bias. Patients in both cohorts were required to be age ≥18 years and have continuous medical and pharmacy benefits 1-year pre- and post-index date. Study outcomes (health care resource utilizations and costs) were compared between the migraine and comparison cohorts. RESULTS: After applying PSM, 380,751 patients were assigned to each cohort, and baseline characteristics were well-balanced. A higher percentage of patients with migraines had inpatient stays (21.53% vs. 11.00%, p<0.0001), other therapy (99.88% vs. 65.78%, p<0.001) and pharmacy visit claims (90.52% vs. 48.35%, p<0.0001), compared to those without a migraine diagnosis. The patients in the migraine cohort also incurred significantly higher other therapy ($4,111 vs. $2,312, p<0.0001) and pharmacy visit costs ($1,074 vs. $512, p<0.0001) than those in the comparison cohort. CONCLUSIONS: Migraine patients incurred significantly higher costs and had higher health care resource utilizations than those without migraines.