Pearl (also known as Margarita or Zhen Zhu in traditional Chinese medicine) has been used historically in East Asian medical systems for a variety of health concerns, including calming the mind, improving skin health, and supporting eye and liver function. Its use for migraine is based primarily on traditional practice rather than modern scientific validation. In traditional Chinese medicine, pearl powder is believed to possess sedative and anti-inflammatory properties, which are thought to help with headaches, including migraines. However, there are very few, if any, rigorous clinical studies specifically investigating the effect of pearl powder on migraine prevention or treatment. The available evidence consists mostly of anecdotal reports and traditional texts, with some small animal or in vitro studies suggesting potential neuroprotective or anti-inflammatory effects. These findings are far from conclusive or directly applicable to migraine in humans. Therefore, while the use of pearl for migraine has traditional roots, scientific evidence supporting its efficacy is minimal, and its clinical use is not supported by robust modern research.