Due to similar neuro-biological mechanisms in migraine and vestibular migraine, pharmacological treatment for vestibular migraine is based on the acute and prophylactic pharmacotherapeutic agents used for classical migraine. The medication trials and studies in the paediatric population are lacking and may not always have statistically proven benefit as in adults. However, several pharmacological medications are available for the treatment of vestibular migraine in children and adolescents. Treating clinicians may need to take into consideration several factors, including child’s age, pubertal hormonal changes, child’s preference on format of medication (such as liquid or tablets) and co-morbidities (such as asthma and body weight) when deciding on drug selection. With careful selection, it is possible to obtain good symptom control, both in reduction of severity and frequency of the episodes.