Lack of knowledge on patients' expectations to treatment may lead to misunderstandings and prevent successful outcome. Presently, treatment of medication overuse headache (MOH) leads to improvement in up to 75% of patients, but the relapse rate may exceed 40%. This study aimed to evaluate the preferences on information and expectations to treatment in patients entering a treatment programme for MOH. A questionnaire on patients' needs and preferences on information and expectations was distributed to 65 MOH patients from specialized headache clinics in Italy, Germany and Denmark. A total of 75% selected personal verbal information as their primary need, significantly higher than the percentage of patients who selected leaflets and website information 35 and 35%, respectively (p <0.001). Telephone and E-mail consultation was requested by 59 and 48%, respectively. The information source preferred was again personal verbal information (82%), significantly higher than all other information sources (p <0.001). In decreasing order, patients preferred telephone consultation (48%), E-mail consultation (44%), website information (41%), and leaflets (33%). 51% expected their headache to be cured, 71 and 57% requested effective prevention and fast relief of the headache episodes. 80 and 75%, respectively expected reduction in frequency and intensity. A total of 64% expected information about self-management and 52% expected to receive education on their headaches. The study demonstrates that patients in specialized headache centres prefer personal information, that expectations are very high, and that education and information are important. Providing the right information and thus give patients realistic expectations might enhance compliance and improve outcome.