<p>Migraine is a debilitating neurovascular disorder affecting over one billion people globally. While reported prevalence in Asia is lower than in Western countries, significant regional variations and unique clinical presentations necessitate a tailored approach to management. From the Advisory Board Meeting of the East Asian Network for Migraine, expert insights and current literature from China, Japan, South Korea, and Taiwan were synthesized to establish a unified perspective on the epidemiological and sociocultural contexts of the region. Patients in these East Asian countries exhibit distinct clinical features, such as a lower frequency of migraine with aura and photophobia, but a higher incidence of osmophobia compared to Western populations. Despite these clear phenotypic differences, significant gaps in care persist. Acute treatments like triptans remain underutilized, and while emerging CGRP-targeting therapies show promise, their adoption is hindered by high costs and limited accessibility. Furthermore, the region faces critical challenges, including a lack of region-specific clinical trials, culturally appropriate assessment tools, and unified clinical guidelines. Optimizing migraine care in East Asia requires a shift toward personalized, culturally sensitive strategies. Experts reached a consensus on the urgent need for collaborative research to address existing disparities and improve patient outcomes. By aligning clinical practice with the unique sociocultural landscapes of these nations, this statement provides a foundational framework for enhanced policy development and improved migraine management across East Asia.</p>