The high incidence and prevalence of headaches in the pediatric population has a significant impact on patients and their families. Migraine, the most common headache disorder for which pediatric patients see a physician, remains underdiagnosed. Recent studies have revealed the increasing incidence of migraine and chronic migraine in the pediatric population. This article presents limitations of the present diagnostic criteria for migraine, and the proposed modifications to these criteria may assist the clinician with early recognition. Further research in pediatric headaches is needed to help reveal additional pathophysiologic mechanisms and improve diagnostic criteria.