Headache is an important clinical symptom commonly encountered by practising physicians. Thorough history and physical examination is a must for arriving at differentials of headache. Headache is divided into-primary and secondary. Myeloproliferative neoplasm induced hyper viscosity and associated headache is an important though a rare entity in clinical medicine. This is the case report of a 60 yr. old female who presented with history of chronic headache which was induced by polycythemia vera, an important myeloproliferative neoplasm. Treatment of MPN associated headache is different from that of normal headache, as it involves treatment of underlying disorder. Main treatment modality involve phlebotomy, cytoreductive therapy-hydroxy urea, low dose aspirin, JAK -1/2 inhibitor-Ruxolitinib. Splenectomy is rarely indicated in present clinical scenario.