Background: Migraine prevalence is rising globally, with shift work identified as a key risk factor. Emergency residents face demanding schedules, yet data on migraine burden in Saudi Arabia’s healthcare workforce remain scarce. Aim: To assess migraine prevalence and shift work-related factors among emergency residents in Riyadh, Saudi Arabia. Methods: A cross-sectional study enrolled 376 emergency residents. A validated questionnaire and Migraine Disability Assessment Test (MIDAS) were used. Statistical analysis included Mann-Whitney U and Kruskal-Wallis H tests. Results: Out of 376 emergency medicine residents surveyed across Riyadh hospitals, 34.3% were diagnosed with migraines, and 44.1% reported a family history. Frequent headache episodes (3-6/month) were experienced by 43.4% of participants, with 34.0% reporting headaches lasting from 5 to 10 minutes. Throbbing or pulsating headaches (56.4%) and one-sided headache locations (50.5%) were the predominant clinical features. Photophobia, phonophobia, nausea, and vomiting were reported by 43.4%, 47.3%, 46.0%, and 38.0%, respectively. Common triggers included sleep disturbances (53.5%), strong smells (33.8%), and lights (33.8%). The median MIDAS score was 7 (IQR: 8), with only 17.3% experiencing severe migraine-related disability. Disability was significantly higher among females, those ≥35 years old, non-Saudi residents, those divorced/widowed, and residents with ≥3 years of experience. Conclusion: Over one-third of emergency medicine residents suffer from migraines, with a considerable proportion experiencing moderate to severe disability. Headache frequency, associated symptoms, and insufficient medical evaluation highlight the need for targeted awareness, early diagnosis, and intervention strategies to reduce disability and improve residents’ well-being and productivity.

Keywords: Migraine, shift work, MIDAS, Migraine disability, residents, Saudi Arabia