Migraine is a widespread disorder with a large impact on society. Patent foramen ovale (PFO) is a common occurrence, affecting about 25 % of the population. Observational studies report PFO to be more prevalent in patients with migraine with aura, and patients with migraine with aura have a higher incidence of PFO. The only population-based study does not support this link. It is possible that an association exists between large-sized PFO and migraine. This association may explain how migraine with aura can be triggered. Numerous studies have reported improved migraine with PFO closure, but the only prospective placebo-controlled trial aimed at closure of PFO in patients with migraine with aura did not support this. At this time, evidence does not support the routine detection and closure of PFO in patients with migraine.