Several studies have indicated that a relationship exists between patent foramen ovale (PFO) and the incidence of migraine; however, the nature of the relationship and whether PFO closure could be used as a treatment for migraine are controversial. In this Viewpoint, Gian Paolo Anzola lists evidence in support of a relationship between PFO and migraine and suggests that, subject to further trials, PFO closure could in the future benefit some patients with migraine.