Background: It is unknown whether clinical parameters differ between migraineurs with and without first-degree family members with migraine. Objectives: The present cross-sectional study describes differences between familial and sporadic migraine with a focus on migraine characteristics, migraine severity, comorbidities, and treatment. Method: From the Danish Headache Center we recruited 358 patients with familial migraine and 1727 patients with sporadic migraine. Each participant was assessed using a validated semi-structured interview. Results: No differences in age (Mean = 44 and 44 [SD = 12.28 and 12.58] for familial and sporadic migraineurs, respectively; P =.900) or sex (295/358 (82.4%) and 1413/1727 (81.8%) women in familial and sporadic migraineurs, respectively; P =.853) were found. Familial migraineurs had more aphasic aura than sporadic migraineurs (41% vs 27%, P =.001). Sporadic migraineurs had more lifetime attacks ie, >100 attacks (45% vs 70%, P <.001) and prolonged attacks ie, lasting >72 hours (5% vs 12%, P <.001) than familial migraineurs. Further, sporadic migraineurs had a higher incidence of concussions (37% vs 41%, P =.001) compared to familial migraineurs. In agreement with a previous study, there was no difference between familial and sporadic migraine regarding triptan response (84% vs 81%, P =.440). Conclusion: Headache characteristics, triptan response, and comorbidities where similar in individulas with and without inherited migraine, suggesting that migraine are to be considered a hmogenoues disease. The difference in the clinical presentation of migraine with aura symptoms among patients with familial migraine should be considered in future studies. Further, more severe migraine among patients with sporadic migraine with aura could suggest that sporadic migraineurs have been exposed to stronger or multiple environmental factors and indicate that an early intervention in migraine treatment could lessen the severity of migraine.