Purpose: Headache is the most frequent presenting symptom encountered in ophthalmological practice. However, it can be an alarming indicator in many neurological disorders and be a potential sign for intervention. The study emphasizes on assessing the etiology of headaches and illustrating the ocular causes. Methods: Our study was a cross sectional, observational study conducted at a tertiary care center over 3 months of duration. Demographic data were collected for all the patients presenting to ophthalmology OPD with primary complaint as Headache along with comprehensive history and detailed ocular examination including Visual acuity, Refraction, Intraocular pressure measurement, Slit lamp examination and fundus evaluation. Cross references from other specialties like ENT, medicine, dentistry, and neurology were taken. Results: Out of 250 subjects in our study, 391 patients (78.2%) directly attended the ophthalmology OPD with headache. In contrast, 109 (21.8%) were referred from other (ENT, Medicine, Dental, Neurology, Surgery) specialties to ophthalmology OPD because of evaluation of headache. Conclusions : A wide range of diseases must be kept in mind when working up patients with headaches with or without ocular pain or visual disturbances. Our study assisted in differentiating and estimating the burden of ocular and non-ocular causes of headaches. Hence, the ophthalmologist is mostly the first physician to triage these patients.