PURPOSE: Headaches occur frequently in the pediatric population and have a significant impact on their quality of life. Several mechanisms are currently thought to contribute to headache pathogenesis. Our aim was to investigate the association of chronic headache in children and cerebral vascular anomaly by performing brain magnetic resonance angiography (MRA). METHODS: We retrospectively reviewed medical records and MRA of 44 patients with chronic headache who visited the pediatric clinic of Young Dong Severance hospital from January 2006 to April 2008. RESULTS: The number of enrolled patients was 44. Eight(18.2%) of them showed abnormal brain MRA findings. Abnormal findings included 5 cases of unilateral A1 hypoplasia, 1 case of unilateral vertebral artery hypoplasia, 1 case of unilateral A1 and P1 hypoplasia, 1 case of Moyamoya disease. Among the 44 patients, 21 had complained only headache and 23 had complained other neurological symptoms with headache. The ratio of abnormal MRA between the two groups showed no statistical difference. CONCLUSION: Vascular anomaly could be a possible pathogenesis and risk factor in chronic headache in children. Further investigation and long term follow up is needed.