Background: The current study aimed to determine the efficacy immunotherapy versus the medical treatment in cases of allergic rhinitis-associated migraine. Patients and Methods: This randomized-controlled study was conducted in Banha Medical University Hospitals, Egypt in the period 2014-2015. Eligible patients having both allergic rhinitis and migraine were randomly allocated to the study group and the control group. For the study group, immunotherapy was used, and for the control group medical treatment was used. The primary outcome measure was the IgE level in both groups after the treatment period. Results: A Forty-one patients were included in the analysis, 20 in the study group and 21 in the control group. The two groups were comparable regarding the baseline characteristics. At the end of the study, there was no significant difference in the IgE level between groups (p-value 0.288) where it was 18.3 (6.0) & 16.5 (5.1) in the study group and the control group, respectively. Also, there was no significant difference in the number of migraine attacks between groups (p-value 0.756) where it was 1.9 (0.7) & 1.8 (0.7) in the study group and the control group, respectively. However, within-group analysis revealed a highly significant reduction in IgE level and number of migraine attacks in both groups (p-values < 0.0001). Conclusions: In conclusion, immunotherapy is as effective as medical treatment for cases of migraine associated with allergic rhinitis.