Although pharmacotherapy with NSAIDs and tricyclic antidepressants comprises the traditional treatment of tension-type headaches (TTHs), the use of other therapeutic approaches in combination with medications can increase the success of treatment. Patients with comorbid mood disorders and unremitting headaches may particularly benefit from some nonpharmacologic approaches. This review focuses on complementary and alternative approaches to TTH treatment, including psychological therapies, acupuncture, and physical treatments.