SUNCT is a rare headache disorder, first described by Sjaastad et al. in 1989 (1) and recently codified by the International Classification of Headache Disorders as a primary headache (2). The literature, however, discloses some cases of secondary SUNCT syndrome, particularly due to lesions in the posterior fossa or involving the pituitary gland (3-10). The pharmacological treatment of this syndrome is problematic. Some encouraging results have been recently suggested with lamotrigine (11-15), gabapentin (16, 17) and topiramate (18, 19); all previous attempts at treatment with drugs used for other short-lasting headaches were unsuccessful (20). It is noteworthy that two reports (21, 22) even reported a worsening effect of verapamil in patients affected by SUNCT. We describe a patient with SUNCT syndrome and an ischaemic lesion in the posterior fossa, who was successfully treated with verapamil.