Neuroimaging can play a vital role in headache evaluation, though its utilization must be judicious and evidence-based. While a comprehensive clinical assessment is always fundamental, imaging is essential for the diagnosis of many headache disorders. There exist several guidelines for headache imaging, but overutilization of imaging and missed diagnoses due to inappropriate imaging selection remain a significant challenge. This article examines the role of neuroimaging in primary and secondary headache disorders, discusses the strengths and limitations of different imaging modalities, and provides a practical framework for optimizing imaging utilization while maintaining resource efficiency.