We examined the socio-economic consequences of headache in a random sample of 514 working people living inthe Republic of San Marino. Our results show that, in the preceding year, 255 out of 514 (49.6%) suffered fromheadache; 31.9% (164/514) reported decreased efficiency as a consequence of headache; 9.3% (48/514) reportedthat head pain is always severe; 7.4% (38/514) were absent from work because of headache for a total of 338working days lost; 8.4% of all working days lost to illness were due to headache.We estimated that in the Republic of San Marino (21,792 inhabitants), headache causes a loss of at least 5,000working days every year. Since the cost of a working day in the Republic of San Marino is about 100,000 italianlire, the economic burden in this area amounts to 500 millions of lire in a year. This shows that headache is amajor socio-medical problem.