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Background and purpose The literature provides strong evidence that physiotherapy can be effective for managing certain types of headaches. While dry needling method in treating myofascial trigger points is gaining popularity, until now there is still limited research supporting its efficacy. The aim of this research was to compare and to prove which of the methods is more effective on treating cervicogenic headache. Material and methods This is a comparative effectiveness research. Subject: Total (n = 100) adults undergoing treatment (Mean ± SD age: 37.05 ± 10.62 years) separated in two groups with 50 patients. Group 1 (convectional physiotherapy plus dry needling)-experimental group. Group 2 (conventional physiotherapy alone)-control group. In this research have been used two questionairs: Neck disability index (NDI) questionaire and visual analog scale (VAS). We did two physiotherapy sessions a week for six weeks, we evaluated the progress in first and in last session, wee did that througt the questionaire and the measurments of the Range of Motion (ROM). Data presentation was done through tables; data processing was done with SPSS software. From the statistical parameters the structure index, arithmetic mean, standard deviation (SD) were calculated. Data were tested by t-test, respectively P <0.05 and P <0.01. Results The study demonstrated that both treatment methods—standard physiotherapy and physiotherapy combined with dry needling—significantly reduced pain and disability in patients with cervicogenic headache (p < 0.01). However, the dry needling group achieved superior outcomes. Pain levels (VAS) decreased from 6.64 to 2.68 in the dry needling group, compared to 6.20 to 3.04 in the physiotherapy-only group. Disability scores (NDI) improved from 3.42 to 2.14 with dry needling, versus 3.38 to 2.20 with physiotherapy alone. Additionally, the dry needling group exhibited significantly greater improvements in cervical range of motion, particularly in flexion (45.90° to 53.76°) and lateral flexion movements (right: 42.62° to 46.44°, left: 42.10° to 47.10°), underscoring its enhanced clinical efficacy. Conclusions Dry needling (DN) has been found to have significant effects on pain, range of motion (ROM) and functional level.