A migraine is a primary headache, and it could be a migraine with aura or without aura, whereas it must accomplish different requests. The trigeminal-vascular system is essential in migraine physiology through bidirectional sensibilization. Migraine surgery consists of a vascular or muscular decompression of the Trigeminal nerve afferent pathways; the surgical trigger points interruption or inhibition through the neurolysis orneurectomies. Migraine surgery works on different levels, depending on the severity of the pain. Local treatments have demonstrated migraine treatment by inhibiting or decompressing muscular trigger points as the botulinum toxin infiltration. This article aims to present the case of efficacy migraine surgery treatment.