Summary: Migraine is a complex brain disorder of sensory processing. Its pathophysiology has not been fully explained, but data are accumulating on inherited genetic factors that predispose the brain to migraine, in a complex interplay with potential trigger factors. There is a huge unmet need in currently available migraine treatments, even more so for prophylactic drugs than for acute drugs. Monoclonal antibodies (mAbs) targeting the calcitonin gene-related peptide (CGRP) pathway have been developed for episodic and chronic migraine prevention, either through binding the CGRP ligand (eptinezumab, fremanezumab, galcanezumab) or the CGRP receptor (erenumab). The efficacy of all four drugs is modest over placebo in episodic and chronic migraine prevention and overall comparable with available oral preventive treatments; current tolerability and safety data of this new treatment approach certainly promise a major step forward for migraine patients.