OBJECTIVES To investigate the prevalence and clinical characteristics of migraine, and to evaluate the current status of migraine diagnosis and treatment in neurological outpatients. METHODS A face-to-face interview survey was conducted in the neurological clinic of a tertiary care hospital during a period of three months. A headache questionnaire for patients who consulted doctors with a chief complaint of headache was completed by a qualified and experienced physician in headache studies during the interview. Migraine diagnosis was made by physicians based on the criteria of the second edition of the International Classification of Headache Disorders. RESULTS Of 9282 patients assessed, 19.5% (1806) complained of headache. The prevalence of migraine was 23.8%(401/1683)among headache patients. The average age of migraineurs was 42.2±13.1 years and 80.5% were female. Of all migraineurs, 68.6% had consulted a physician for headache in the previous one year, and only 13.5% had received a physician diagnosis of migraine. A total of 173 migraine patients (43.1%) had not taken any analgesic for acute treatment in the previous three months and only 11 migraineurs (2.7%) had used preventative medications. Medication overuse was significantly more common in male than in female patients with migraine (P<0.01). CONCLUSIONS Migraine is the most common headache disorder in the neurological clinic and it remains underrecognized and undertreated in China. Public health initiatives to improve diagnosis and treatment of migraine are needed.