Objective.-To determine whether chronic Helicobacter pylori infection is a risk factor for migraine. Background.-Preliminary studies have shown a high prevalence of Helicobacter pylori infection in patients with primary headaches.Methods.-One hundred three consecutive patients with migraine were enrolled in the study and compared with a group of 103 matched controls. Helicobacter pylori infection was diagnosed by means of both 13 C-urea breath test and serology.Results.-Of patients with migraine, 30.1% were positive for Helicobacter pylori , compared with 31.1% of controls ( P ϭ NS). The odds ratio for migraine associated with chronic Helicobacter pylori infection was 0.96 (95% confidence interval, 0.51 to 1.80). Demographic, clinical, and psychological characteristics of Helicobacter pylori -positive migraineurs were compared with those of migrainous patients without infection. Helicobacter pylori -positive patients had a significantly ( P Ͻ .05) lower incidence of food sensitivity than Helicobacter pylorinegative patients. No significant difference was found in any other feature examined.Conclusions.-Our study suggests that chronic Helicobacter pylori infection is not more frequent in patients with migraine than in controls and that infection does not modify clinical features of the disease.Key words: migraine, aura, Helicobacter pylori , food sensitivity Abbreviations: H. pylori Helicobacter pylori , UBT 13C-urea breath test ( Headache 2000;40:836-839) Helicobacter pylori ( H. pylori ) is a gram-negative organism that causes chronic active gastric inflammation. Infection is strongly associated with duodenal ulceration, gastric ulceration, and gastric cancer. 1,2 Several case-control studies have reported a significant association between chronic H. pylori infection and obstructive vascular diseases such as acute myocardial infarction, primary Raynaud phenomenon, and ischemic stroke. 3-5 Several mechanisms could link chronic H. pylori infection and vascular diseases including a low-grade acute phase response, free radical formation, and immune-mediated mechanisms. [6][7][8] However, the precise mechanism by which chronic H. pylori infection mediates these vascular effects remains unclear.A recent preliminary study reported that 40% of patients diagnosed as having primary headache were seropositive for H. pylori infection. 9 Furthermore, eradication of the bacterium resulted in a significant decrease in intensity, duration, and frequency of migraine attacks. 10