Post-traumatic headache (PTH) is classified according to the intensity of the traumatic brain injury and is either acute or persistent with the latter defined as greater than three months. Migraine-type persistent PTH after mild traumatic brain injury (mTBI) or concussion is somewhat controversial but is now a focus of intense preclinical and clinical research. The prevalence of concussion is not known precisely but once injured, persistent symptoms, especially PTH, do occur and the symptoms persist as, for example, nearly half of a cohort of injured Veterans report chronic daily headache 11 years after injury. The relationships between post traumatic headache and primary headaches, especially migraine, are complex and controversial and in this review, we discuss the preclinical and clinical similarities and important differences. Treatment options are also discussed.