OBJECTIVES: This study aimed to evaluate the real-world healthcare resource utilization due to migraine, particularly among individuals who suffer from at least 4 monthly migraine days (MMDs) and may be eligible for, or receiving prophylactic treatment. METHODS: A cross-sectional study was conducted using an online survey of migraine patients across 31 countries (Africa, America, Asia and Europe), recruited via online panels and patient organizations. Study participants were adults (>=18 years) who reported having >=4 MMDs over the 3 months preceding the time of the survey (September 2017-February 2018), with pre-specified 90% among those having reported having used preventive migraine treatment. RESULTS: A total of 11,266 migraine patients responded to the survey (75% women, mean age: 39 years old). Migraine patients with at least 4 MMDs reported visiting different healthcare professionals (HCP) in a 6-month period due to their migraine. In the previous 12 months, 38% of patients visited the Emergency room (ER) an average 3.3 times, and 23% stayed in hospital overnight for an average of 3.2 days. Brain scans were performed on 58% of patients on average 2.1 times. These proportions were both higher in Turkey, India, Brazil, Indonesia, Poland, USA, Portugal, Russia, and also for migraine patients who have failed >=2 prophylactic treatments. CONCLUSIONS: Migraine patients (>= 4MMD) reported a high rate of HCP, ER visits and overnight stays in the hospital due to migraine; results indicate that the burden is higher among those who have failed a prophylactic migraine treatment and this trend increased with the number of prophylactic treatment failures.