Background: Previous studies have linked migraine to weather conditions, but variations in the factors examined and inconsistent focus have complicated comparisons. This underscores the need for a more comprehensive and clearer analysis.

Methods: Studies published before December 2024 on the association between weather and migraine were searched from PubMed, Embase, Web of Science, and Cochrane. Meta-analyses based on effect sizes were performed using Review Manager version 5.4.1.

Results: A total of 31 studies were included in the meta-analyses. It revealed a significant association between migraine attack and weather changes reported as a trigger factor (RD = 0.47, 95% CI = 0.40-0.54). Additionally, specific weather factors, such as temperature (OR = 1.15, 95% CI = 1.02-1.29) and ambient pressure (OR = 1.07, 95% CI = 1.01-1.15), were significantly associated with migraine attacks, while humidity (OR = 1.04, 95% CI = 0.97-1.11) did not show a significant association. Moreover, increased levels of air pollutants, including PM10 (OR = 1.07, 95% CI = 1.03-1.11), PM2.5 (OR = 1.04, 95% CI = 1.01-1.06), NO₂ (OR = 1.08, 95% CI = 1.03-1.14), CO (OR = 1.08, 95% CI = 1.01-1.16), and O₃ (OR = 1.12, 95% CI = 1.03-1.21), were significantly associated with an increased risk of migraine clinical visits, whereas SO₂ (OR = 1.02, 95% CI = 1.00-1.04) was not.

Conclusions: This meta-analysis revealed that weather changes are significant trigger factors for migraine, with temperature and ambient pressure playing notable roles in this association. Additionally, increased levels of air pollutants are linked to a higher risk of migraine attacks. These findings could lead to new interventions for patients who are weather-sensitive and offer fresh perspectives for future research into the pathogenesis of migraine.