Introduction: Migraine is the most frequent primary headache in pediatric population. Migraine incidence increases with age, affecting 11% of children between 5 and 15 years. Up to 25% of patients require preventive treatment due to high frequency, severity or repercussions of episodes. Topiramate has proven effective for migraine. Objective: Assess response and safety of Topiramate for migraine in a pediatric population. Methods: Prospective study between 04/01/2008 to 10/31/2013 at the Headache group, Pediatric Neurology Department, Pereira Rossell Children`s Hospital, Montevideo, Uruguay. We included children up to 15 years old with migraine, classified according to the International Classification of Headaches Disorders, 2^nd Edition. Topiramate was introduced in patients with 3 or more episodes per month. We started with 0,5mg/kg/day, increasing dose to 1mg/kg/day, maximum 2mg/kg/day or 100mg/day. Effectiveness was considered when a 50% or more reduction in episodes occurred. Adverse effects were assessed by questionary to patients and their family. Results: 190 patients with primary headaches consulted in this period, 121 (63.9%) had migraine. In the migraine group 59% (n=72) were girls, mean age was 9.63 years. 58 patients (48%) were treated with Topiramate, 60% (n=35) were girls and mean age was 9.94 years. Topiramate reduced episodes in 89.6% (n=52) of patients. In 2 patients there was no response to treatment and in 6 patients treatment was discontinued due to worsening of headaches or secondary effects (gastrointestinal, fatigue, muscular weakness). Secondary effects disappeared after treatment discontinuation. Conclusions: Topiramate is effective and secure for migraine preventive treatment.