Introduction: Migraine is a widespread neurological disorder that significantly affects quality of life. However, data on its burden in China remain limited. This study analyzes long-term trends (1990–2021) and projects future patterns. Methods: Using the Global Burden of Disease (GBD) 2021 database, we examined migraine incidence, prevalence, and disability-adjusted life-years (DALYs). Temporal trends were assessed via joinpoint regression, while age-period-cohort (APC) analysis and decomposition analyses identified key influences. Bayesian APC modeling projected future trends through 2035. Results: Migraine imposes a substantial health burden in China, with an annual incidence of 13.04 million cases, a prevalence of 184.75 million cases, and 6.98 million DALYs cases. Females are disproportionately affected, with peak prevalence occurs in the 30–49 age group. Individuals born post-1960 show increased susceptibility, as linked to demographic and lifestyle shifts. Population growth is a major driver of rising prevalence, with projections indicating a continued increase through 2035. Conclusion: Migraine remains a significant public health concern in China, particularly among women. Targeted prevention, early detection, and intervention strategies are essential to mitigate its growing burden.

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