The literature pertaining to conversion headache is briefly reviewed and problems with definition are discussed. There is often confusion about the concept of “psychogenic” headache and whether or not there are underlying local physiological changes present in cases of conversion headache. For the purposes of this paper conversion headache is defined as a headache in which the prevailing clinical disorder is a conversion reaction and a peripheral pain mechanism is not present. A case will be described to provide a clinical description of the disorder and to demonstrate some of the features that can be helpful in establishing the diagnosis. Discussion considers factors important in the pathogenesis and diagnosis of conversion headache, such as the significance of symbolization, secondary gain, and other features associated with the conversion reaction.