Tension-type headaches are extremely common and are in some cases characterized by severe socio-economic burden and reduced quality of life. Currently there is a great room for improving research in regarding most aspects of tension-type headaches. The connection of physical and psychological factors has been identified but the magnitude of each factor in the pathogenesis of tension-type headaches still remains unclear. Despite the establishment of multi-factorial relationship in the pathogenesis of tension-type headaches and many theories applied, no clear etiology has been found. Current theories suggest that peripheral pathomechanisms associated with myofasciae is the most important factor for infrequent tension-type headaches and central processes such as spinal and supra-spinal sensitization are more involved in chronic cases of tension-type headaches. There are several treatment modalities that are available for patients with tension-type headaches. The recommended drug therapies in the case of acute tension headaches include simple analgesics and non-steroidal anti-inflammatory drugs. In chronic cases, pain killers should be avoided and replaced with prophylactic therapy.