Background: Migraine is considered as a neurovascular coupling disorder where the cerebral vascular reactivity is malfunctioning and measuring hemodynamic changes during migraine without causing more disturbances has always been a challenge. Objective: This study aimed to detect the role of transcranial Doppler ultrasound in assessing the vasomotor reactivity of cerebral blood vessels in migraine patients. Patients and Methods: This case control study included thirty-two migraine patients and thirty-two healthy individuals that were recruited from Neurology Department at Zagazig University Hospital and Neuropsychiatry Department at El-Sahel Teaching Hospital Outpatient Clinics during the period from April to December 2020. We performed Transcranial Doppler (TCD) on all participants and Breath Holding Index (BHI) was measured on both sides from the middle cerebral artery (MCA). Results: There was a significant decrease in breath holding index in patients of migraine. There was a statistical significance decrease in BHI and Maximum flow velocity in the left MCA (Max. FV Lt MCA) among severe patients compared to moderate patients. Conclusion: Migraineurs have significantly lower BHI compared to control group. The noninvasiveness of TCD and the possibility it provides for obtaining instantaneous information about cerebral blood flow changes indicates its usefulness in the study of vascular changes in different types of migraine.