59 patients with cluster headache are discussed. Treatment can be divided into treatment of the acute attack, and prophylactic treatment. The acute attack can be interrupted in most cases by ergotamine, either sublingually or in the form of suppositories. A number of patients respond to the inhalation of pure oxygen. Most patients with the episodic type of cluster headache do well on prophylactic treatment with methysergide. If they prove refractory to this drug, treatment with lithium salts can be instituted. Most patients with the chronic type of cluster headache respond favourably to lithium therapy.