The few existing studies that have explicitly examined appraisal of stress in tension-type headache sufferers have found that these individuals perceive events in a more negative manner than headache-free controls. However, can it necessarily be assumed that they perceive events in a less accurate manner than headache-free controls? To answer this question, sixty chronic tension-type headache sufferers and 60 controls engaged in a 40-trial contingency learning task in which they had to estimate the amount of control they could exert. Results provide little support for the notion that the cognitive appraisal of tension-type headache sufferers is more accurate than that of headache-free individuals. However, differences were found in perceived control when behavioral involvement was considered. This result is discussed in terms of learned helplessness theory.