In this case report, a 41-year-old man who had been suffering from cluster headache since the age of 15 years old was treated with high dose vitamin B1 (thiamine). He had been diagnosed with cluster headache at a neurological center in Italy. His first headache occurred at age 15 shortly after a motorcycle accident and they increased in frequency over the years, with acute pain and intensity that significantly compromised his quality of life. Although the patient would experience some headache free months over the years, in January 2016 the headache clusters began occurring daily with no pain-free period for an entire year. The patient had been treated with sumatriptan, a commonly prescribed drug for cluster headache, which did not work. He had also been prescribed prednisone, although this not alleviate the pain either. In December 2016, he was given oral high dose vitamin B1. Initially, the dose was 250mg, then it was increased to 750 mg after a few days. Within 10 days, the headache pain disappeared. He continued the vitamin B1 daily indefinitely.