Migraine has an estimated prevalence of 11.4% in Italy and is associated with significant morbidity. OBJECTIVE: To estimate resource consumption (RC) and costs related to migraine in Italy. METHODS: This was an observational, multicenter survey of a patient population attended by general practitioners (GPs). Patients who visited their GPs on five consecutive days of two different weeks were asked if they suffered from headache. Patients with headache were asked to participate in the study if their condition met the International Headache Society criteria for migraine. Migraineurs received a diary in which to record attacks and treatments. During subsequent GP visits, patients were administered an RC questionnaire on medical services and lost workdays due to migraine. Assessment of RC was from the community perspective. Values were assigned according to official sources, and average annual costs in Euro (E) per patient were calculated. RESULTS: During the first trimester of 1996, 902 GPs collected data on 71,588 evaluable patients. Prevalence of migraine in the sample was 11.6%. Health care resources (direct costs) accounted for 52.4% of the total annual cost, while lost workdays (indirect costs) accounted for the remaining 47.6%. The total annual cost per migraneur was E599. Direct costs included: medical consultations E49 (8% of total); tests E63 (11%); drugs E43 (7%); and hospitalizations E157 (26%). A total of 2.8 workdays per patient were lost annually due to migraine. Extrapolated to the total (active) population in Italy, this corresponds to 15,016,870 lost workdays, amounting to over E1.5 billion in indirect costs per year. As Italian migraneurs exceed 5,440,000, the total annual cost of migraine in Italy is over E3.2 billion. CONCLUSIONS: Migraine is a costly condition, both in terms of direct and indirect costs. Better therapeutic control should dramatically reduce costs related to healthcare resource consumption and lost workdays due to migraine.