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Considering that migraine patients ask for the physician's help in outpatient clinics and hospitals due to the acute attacks dominated by headaches, the latest research in pathophysiology and pharmacotherapy of migraine, directed the aim of this research to investigate the efficiency of dihydroergotamine in the treatment of the acute attacks of migraine headaches and to define a treatment program of the acute migraine headaches for the out patient and in patient conditions. The investigations were performed in 34 patients of the middle age and younger, of both sexes, with the established clinical diagnosis of a common migraine, with no history of coronary disease, ischemic brain disease, kidney and hepatic deficiency, and who were not for different reasons, Under the prophylactic therapy. Patients were randomly divided into two equal groups. The first group was treated i.m. with dihydroergotamine (1 mg) in combination with metoclopramide (10 mg). In case of insufficient effect the dose was repeated after one and eight hours after the first dose. The second group was treated with diclofenac (75 mg) and metoclopramide (10 mg), using the same pattern. The results investigation showed the significantly better effect of dihydroergotamine regarding the onset and the intensity of the positive effect. It was concluded that in case of acute attacks of migraine headaches in younger patients with no history of coronary disease, ischemic brain disease, kidney and hepatic deficiency, dihydroergotamine with metoclopramide administered i.m. could be used as a therapy of choice in all treatment conditions.