We assessed microcirculation in nailfold capillaries of 22 patients with classical migraine and 22 normal subjects matched for age and sex using video-microscopy. Blood flow measurements were performed under standardized room temperature, after a 3-min warm water bath and after local cooling. Under standardized conditions, skin temperature at the fingertip was significantly lower in patients with migraine. Morphological differences, however, could not be found between patients and controls. After cooling of the nailfold area, blood flow stop due to vasospasm occurred in 18 of the 22 migraine patients in contrast to 1 of the 22 control subjects only. Capillary blood cell velocity was significantly decreased in the migraine group under all test conditions. Drug treatment did not account for the different prevalences of vasospasm in migraine patients and normal controls. Our findings demonstrate that patients with migraine often have subclinical microcirculatory disorders of the upper limbs.