There have been two previous case reports of complicated migraine headaches associated with the use of beta blockers. In this article we report a third case of complicated migraine in a patient with longstanding migraine headaches taking propranolol for hypertension. Visual field testing demonstrated a left homonymous hemianopsia and CT scan revealed a low density defect in the left posterior parietal-occipital area without enhancement. A review of the literature on stroke in migraine and the mechanism of action of beta-blockers are included. We question the appropriateness of the use of beta-blocking agents for prophylaxis of migraines associated with or preceded by conspicuous sensory or motor deficits.