Preventive medications help reduce the frequency and severity of migraine, leading to improvements in migraine impact, functioning and quality of life. A wide range of oral prophylactics is available and should be selected with consideration of comorbidities and side-effect profiles. Injectable therapies, including onabotulinum toxin A and disease-targeted calcitonin gene-related peptide antagonists, are also effective. Therapy needs to be individualised, particularly for specific patient groups.