If a migraine attack takes more than 72 hours it is called status migrenosus (SM). The most important contributing factor in SM is prolonged excessive use of anti-migraine drugs. Before starting any treatments for SM, severe causes underlying the prolonged pain should be excluded. The cornerstones of pharmacological therapy for SM are parenterally administered anti-inflammatory drugs and triptans as well as valproate and dopamine antagonists. With regard to long-term prognosis, the recognition and treatment of medication overuse headache is essential.