BACKGROUND: Headache is one of the most common disorders, and shows ethnic or geographic diversities. Moreover, the prevalence and epidemiologic characteristics of headache, especially in people living in an island area, is lacking. Therefore, we investigated the prevalence and subtypes of headache in an island area of Korea. METHODS: We collected the demographic and clinical data of all residents living in the survey island area. A neurologist interviewed 352 respondents in a face-to-face method. The specific headache diagnosis was based on the diagnostic criteria of the International Headache Society. RESULTS: The survey island area represented a typical aging society like that of a rural area in Korea. Tension-type headache was the most common type. The prevalence of migraine, tension-type headache, and other headache were 4.0%, 7.1%, and 1.7%, respectively. Migraine with aura occupied 1.7% and migraine without aura occupied 2.3%. Episodic tension-type headache occupied 6.5% and chronic tension-type headache occupied 0.6%. Migraine showed a peak prevalence below the third decade of age and tension-type headache showed a peak prevalence above the sixth decade. CONCLUSIONS: This study showed a characteristic pattern of the prevalence of headache in an island area of Korea. We thought this low prevalence of headache might be due to not only subject age but also social-environmental factors. This study may be helpful in understanding headaches and can provide some basic information for future studies.