Background Primary headaches are remarkably prevalent worldwide and increasingly reported among children. However, the exact trend in this age group, particularly in the gulf region, remains scarce. Aims and Objectives To examine the prevalence of primary headache disorders among primary and middle school students in Kuwait. Methods We conducted a cross-sectional study that included Kuwaiti primary and middle school children and adolescents of both genders in randomly selected schools located

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... two governorates in Kuwait in 2018/2019 academic year. Prevalence and attributable burden of headache, definite and probable migraine,definite and probable tension-type headache, chronic headache ≥15 days/month and probable medication over use headache were assessed using the Headache-Attributed Restriction, Disability, Social Handicap and Impaired Participation (HARDSHIP) questionnaire for children and adolescents. Results Of 1485 questionnaires that were distributed, 1091 students completed the questionnaire with a respondent rate of 73.4%. The study population consisted of 422 boys (38.68%) versus 669 girls (61.32%) students with a mean age of 11.5 ± 2.11 years. The lifetime prevalence of any headache was 85.2%, whereas the one-year prevalence of primary headache disorders was 42.71% The mean age of students with primary headaches was 11.98 ± 2.03 years in both genders. When stratified according to diagnostic criteria, migraine headaches were the most frequently reported (20.81%) followed by tension type headaches (18.7%), chronic headaches (2.75%), and probable medication-overuse headaches (0.46%.). Primary headaches were more frequently reported in middle school compared to primary school (50.37% versus 30.48%; P<0.02). It was significantly higher among girls compared to boys in middle-schoolers (66.46% versus 38.49%; p<0.001), however no significant difference in gender among primary school students(33.12% versus 22.33%; p<0.118). Conclusion Primary headaches are remarkably common in Kuwaiti school students with migraine headache being the most frequently reported type. Age and female gender play a role in the development of primary headaches. The results attract attention of health services for such group and the need for further epidemiological researches.