Occipital nerve stimulation may provide pain relief for patients with otherwise refractory primary headache disorders. While this treatment modality remains an off-label use of spinal cord stimulator technology, a growing body of literature documents surgical techniques, stimulation parameters, complications, and outcome of this novel form of neuromodulation. This chapter will review occipital nerve stimulation, including surgical techniques and complications noted in the literature. A discussion of stimulation parameters used for occipital stimulation will be included. Prospective, blinded studies of occipital nerve stimulation may clarify the role of occipital stimulation in chronic headache management.