Prevalence, Risk Factors, and Management of Migraine among the Adult Population in Saudi Arabia: A Review

Abstract

Background: Migraine is a common and disabling primary headache disorder. Evidence from Saudi Arabia includes national surveys and numerous population subgroups, but differences in sampling and case ascertainment complicate interpretation of prevalence, associated factors, and management outcomes. Aim: To synthesise evidence on the prevalence, risk factors, and management of migraine among adults living in Saudi Arabia. Methods: PubMed, Scopus, and Web of Science were searched for English-language primary studies published from 2016 to 10 July 2026. Findings were synthesised narratively because populations, diagnostic methods, and outcomes differed. Methodological limitations were assessed descriptively. Two reports with mixed adolescent–adult samples were separated from the adult-focused synthesis when adult-only findings could not be established. Results: Of 652 records, 25 reports were retained; 23 contributed to the adult-focused synthesis and two were retained only as mixed-age context. Two national reports analysed the same 2,316 participants. The population-based survey estimated an adjusted one-year migraine prevalence of 25.0%. Other estimates reflected different populations and measures and were not combined into a single prevalence range. Female sex and psychiatric symptoms were associated with migraine in several surveys, without establishing causal direction. Two retrospective onabotulinumtoxinA reports described reductions in headache frequency or disability, but lacked untreated comparison groups. Medication-overuse headache and reported analgesic use were associated with poorer migraine-related quality of life. Conclusion: Migraine places a substantial burden on adults living in Saudi Arabia. Population-based estimates should be distinguished from screening positivity and clinic or occupational proportions. Saudi observational treatment reports describe improvement but do not independently establish comparative effectiveness. Heterogeneous, predominantly cross-sectional primary studies limit the certainty of the synthesis.