Objectives: The study aimed to investigate the relationship between the triglyceride-glucose (TyG) index and white matter changes in patients with migraine. Patients and methods: In this prospective case-control study, brain magnetic resonance imaging, fasting triglyceride levels, and fasting glucose levels of 80 patients (69 females, 11 males; mean age: 31.7±9.8 years; range, 19 to 57 years) with migraine and 50 controls (39 females, 11 males; mean age: 29.6±8.6 years; range, 18 to 50 years) were evaluated between January 2023 and January 2024. Headache intensity, frequency, and characteristics were recorded. Headache disability was measured using the MIDAS (Migraine Disability Assessment). White matter hyperintensities (WMHs) were assessed with the Fazekas scale. The TyG index was calculated with the following formula: fasting triglycerides (mg/dL) ¥ fasting glucose (mg/dL)/2. Results: Based on the Fazekas score for white matter hyperintensities (WMHs), the TyG index was significantly higher in patients with Stage 1 and Stage 2 compared to those with Stage 0 (p=0.038). Conclusion: The findings suggested that an elevated TyG index was associated with the development of WMHs in patients with migraine.