Abdominal migraine in children is a migraine variant, described as isolated, paroxysmal attacks of severe periumbilical abdominal pain associated with nausea, vomiting, pallor, anorexia, headache, and photophobia, with intervening periods of normality. Abdominal migraine is a diagnosis of exclusion, as presenting symptomatology can also be characteristic of other disease processes. An extensive history and physical examination are necessary to differentiate between abdominal migraine and acute abdominal pain. Limited studies have been conducted on the management of children with an acute abdominal migraine attack. Treatment and prophylaxis of acute attacks is essential to reduce recurrence, severity, and extent of pain.