Intravenous hydration (IVH) as a sole therapy for pain has been frequently used in the treatment of a variety of headache syndromes, including severe migraine, postdural puncture headache, and those due to dehydration, despite limited evidence of efficacy. Additionally, IVH is an integral component of many continuous infusion therapies, given the need for both a diluent and carrier for the desired agent. As a therapy or adjunct, IVH should be administered with the same caution as with any intravenous medication, given its physiological interactions and potential for adverse effects. A thorough understanding of these medical considerations, whether IVH is used as a primary or secondary therapy, is essential to ensure maximum patient safety and comfort.