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The present study was conducted to explore the association between adherence to Mediterranean dietary pattern and migraine headache features including frequency, duration, and severity, as well as patients' migraine-related disabilities among the Iranian population diagnosed with migraine. In the present cross-sectional study on 262 migraine patients aged 20-50 years old, a validated 168-item, food frequency questionnaire was used to assess the dietary intakes of participants. The Mediterranean diet score was calculated for each subject using nine pre-defined dietary components and ranged from 0-9. The headache severity, duration, frequency, migraine headache index score (MHIS), and headache impact test-6 (HIT-6) were measured using related questionnaires. After controlling for potential confounders, Mediterranean diet tended to be associated with lower headache frequency (β = −1.74, 95% CI: −3.53,0.03) and duration (β = −0.28, 95% CI: −0.59, −0.02) and was significantly associated with lower MHIS (β = −29.32, 95% CI: −51.22, −7.42), and HIT-6 score (β = −2.86, 95% CI: −5.40, −0.32) for those in the highest category of Mediterranean diet scores compared to the lowest category. A subgroup analysis of women also revealed a negative association between Mediterranean diet and headaches frequency (β = −2.30, 95% CI: −4.27, −0.32), duration (β = −0.42, 95% CI: −0.78, −0.07), scores of MHIS (β = −47.44, 95% CI: −71.90, −22.99), and HIT-6 (β = −3.45, 95% CI: −6.29, −0.61), after controlling for potential confounders. The present study suggests that adherence to the Mediterranean dietary pattern is associated with lower headache frequency, duration, MHIS, and HIT-6 score. [ABSTRACT FROM AUTHOR]