The vascular endothelial dysfunction has been implicated in the pathogenesis of migraine. Oxidized low-density lipoprotein (ox-LDL) may impair endothelial function. Paraoxonase-1 (PON-1) prevents oxidative modification of LDL cholesterol (LDL-C). So we investigated serum PON-1 and arylesterase (ARE) activities, PON-1 55L/M and 192Q/R polymorphisms and the serum lipid profile in patients with migraine. Biochemical parameters and PON-1 polymorphism analyses were assessed in 104 patients with migraine and 86 healthy subjects. Ox-LDL was detected by ELISA, and polymorphisms were determined using PCR-restriction fragment length polymorphism analysis. Patients with migraine had lower PON-1 and ARE activities (p<0·001, for both) and higher ox-LDL and LDL-C levels (p<0·001, for both) and ox-LDL: LDL-C ratio (p<0·005) than the controls. The genotype distribution and the allele frequencies for PON-1 55L/M and 192Q/R polymorphisms were not different among the study populations. The results of our current study indicate that migrainous patients have decreased serum PON-1 and ARE activities and increased serum ox-LDL levels, which may have a clinical importance in the treatment of migraine. © 2011 John Wiley & Sons, Ltd.