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Introduction: The pulsed electromagnetic field (PEMF) therapy for the migraine has weak supportive evidences. The aim of the study was to investigate the effect of PEMF therapy on the refractory migraine (RM). Method: 30 RM kept 2 weeks, baseline log of headache activity prior to being randomized to having placebo or active treatment of PEMF for 30 minutes per session and 3 days per week, for 2 weeks. The 16 patients of the active group also were exposed to added 2 weeks and kept the migraine dairy log 4–8 follow–up months. The parameters of PEMF were squared electromagnetic pulses with 10 Hz frequency and 4–5 mT intensity. Results: The resuts an improvement in the headache days (P<0.002), intensity (P<0.04) and duration of headaches (P<0.001), work–lacked hours (P<0.03) and numbers of medications (P<0.02) because of headache in the real to compare with placebo group after 2 week. Whiles the menstrual cycle only effect on the intensity of headache. To analyze the persistency of treatment in the real group, mixed model ANOVA indicated significant improvement in the days and duration of headaches (P<0.000), work–lacked hours (P<0.01) and numbers of medications (P<0.006) because of headache. The menstruated dependency only had interaction in the intensity of headache. Then the PEMF decreased the intensity in the intensity of headache. Then the PEMF decreased the intensity in the non–menstrual migraine patients. MIDAS scores was significantly decreased after treatment (P<0.000). Conclusion: PEMF (10 Hz, 5mT) had high beneficial prophylactic effect with good persistency in the treatment of refractory migraine. The important note is to control the appropriated dose and response of patient that should be to evaluate.<\div>

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