It has been suggested that contact point can trigger headache in individuals with migraine. In this article, we review the anatomy of the sinonasal cavity. We then define contact points and discuss the pathophysiology of contact point headaches. We propose a theory to explain the relationship between migraines and contact points. We close by presenting our personal casuistic in the surgical treatment of patients with contact point and refractory headaches. In migraineurs with contact point, surgery may improve the headaches.