Patent foramen ovale (PFO) is associated with ischaemic stroke and migraine with aura (MA), and has been proposed as a cause of both. Numerous studies indicate that percutaneous PFO closure can improve MA, but they all suffer from methodological problems. It is recommended that the advantages and risks of PFO closure be carefully assessed in each individual, bearing in mind that effective prophylactic medications are available for MA patients with high attack frequency.