Migraine is one of the leading causes of emergency department visits for headache, representing a significant burden on emergency care systems and patient quality of life. Despite the frequency of ED migraine visits, significant variability exists in treatment approaches, with limited high-quality evidence to guide optimal pharmacologic selection. This network meta-analysis provides emergency clinicians with comparative effectiveness data across multiple treatment options, enabling more evidence-based decision-making for acute migraine management. The findings suggest that chlorpromazine and prochlorperazine should be prioritized for pain relief, while metoclopramide-NSAID combinations may be preferred when avoiding rescue medications is the goal. These medications are already available in most emergency departments, making implementation immediate, though the authors note that further randomized controlled trials are needed to more robustly establish optimal treatment protocols and better characterize relative safety profiles.