OBJECTIVES: To compare the psychometric properties of migraine specific health related quality of life instruments based on McHorney and Tarlov (1995). METHODS: Eleven instruments were identified based on the following criteria: at least one peer reviewed publication of the instrument; instrument focus on HRQOL; psychometric data and instrument availability. Identified instruments were evaluated based on the McHorney and Tarlov's (1995) criteria for individual decision making and included: item information; administration time (practicality); instrument breadth; depth (floor and ceiling effects < 15%); reliability (internal consistency and test-retest) and validity. RESULTS: Five migraine specific health related quality of life Instruments were identified: the Migraine Specific Quality of Life Questionnaire (MSQ); Migraine Disability Assessment Score (MIDAS); 24hr Migraine Specific Quality of Life Questionnaire (MQoLQ); Migraine Specific Quality of Life Measure (MSQOL) and the Headache Impact Test-6 (HIT-6). Ideal psychometric properties were not shown by any of the five instruments evaluated based on study criteria. This was in part due to lacking psychometric data in addition to failure to meet study criteria. For example, MSQ was the only questionnaire available with reported depth and internal consistency data. MSQ, MIDAS, MQoLQ were the most frequently used questionnaires. MSQ was notable for the most extensive psychometric data to support the scale including adequate item information, breadth, depth (floor and ceiling effects < 10%) and validity (multitrait-multimethod, convergent, known groups and confirmatory factor analysis). Although internal consistency for all the dimensions of MSQ (a = 0.86-0.96) was adequate for group level decision making (a > 0.7), some of the dimensions did not meet study criteria for individual decision making. CONCLUSION: The Study results do not support the use of any of the evaluated instruments for individual decision making. Based on available psychometric data, use of MSQ for group level decision making for clinical trials is recommended.