Migraine is a common disabling disorder that affects approximately 12% of the population. Migraine treatment requires the avoidance of triggers, acute treatment to control individual attacks, and preventive treatment for patients with frequent headaches. The choice between the different drugs available for the acute management of migraine is based on the severity of the attacks and associated symptoms. Migraine-specific acute therapies, such as triptans, are recommended in patients with moderate or severe migraine attacks and also for mild episodes that do not respond to simple analgesics. The use of simple analgesics is appropriate for mild attacks or patients who cannot use triptans. Currently, ergotics are not recommended in de novo migraine patients mainly because of their lower efficacy compared to triptans and their side-effect profile. Novel methods for delivering triptans and ergotics will increase the efficacy and reduce the side effects of current formulations. New acute migraine therapies without vasoconstrictive activity and a better side-effect profile than triptans are under investigation. This review focuses on drugs to treat acute migraine attacks and covers a comprehensive selection of emerging therapies.