Motivation is recognized by many physicians as a critical component of any comprehensive treatment program for the migraine patient. To study the role of patient motivation, eighteen migraine patients were entered into a non-medicinal treatment program to include counselling, biofeedback, stress reduction, dietary restriction, exercise, and sleep pattern adjustment. Patients were divided equally into the following groups: military and civilian flyers who were not permitted maintenance medication to remain on flying status; fertile females who were not practicing birth control; and patients who for various reasons desired no maintenance medication. After six months, the first group (flyers) showed significant improvement in reference to both frequency and duration of headache; the second group (fertile females) showed improvement to a lesser degree; and the third group (varied) showed only minimal improvement. This limited study suggests that patient motivation is a significant determinant in the success of a migraine treatment program.