Migrainous infarction is a rare ischemic complication of migraine. According to the definition provided in the third edition of the International Classification of Headache Disorders (ICHD-3), it is a specific clinical entity in the complex relationship between stroke and migraine. Our exemplary case illustrates the main characteristics of this disorder: a young female patient, with no traditional risk factors for stroke, who experienced a worsening of symptoms following a migraine with aura attack that started with her usual aura manifestations. She sought medical attention after hours, being concerned by the worsening of visual symptoms and long duration. Brain imaging allows the diagnosis of ischemic stroke. Migrainous infarction diagnosis was possible because her symptoms started during a typical migraine with aura. In this chapter, we review the pathophysiology, risk factors, clinical presentation, diagnostic workup, and management of migrainous infarction.