BACKGROUND: Headaches are common among schoolchildren, who seem to be afflicted increasingly. AIM: To analyse children's descriptions of their headaches and their thoughts about them, it being assumed that children have insight into the conditions that affect their health. DESIGN OF STUDY: Interview study. SETTING: Two state schools in the city of Malmö, Sweden. METHOD: Fourteen children aged between ten and 12 years, who had gone to the school nurse more than once during the previous two-month period complaining of a headache, took part in thematically structured interviews. Qualitative analysis was performed, aimed at identifying the basic themes involved. RESULTS: The children were found to consistently associate their headaches with conditions in school, specifically with more theoretically-oriented subjects (maths or Swedish), a noisy and disorderly school environment, and insecure relations with classmates. The second theme they took up was insecurity or conflict within the family. Reports of this constituted a major part of the children's accounts of their life situation, despite their failing to link such matters with their headaches. Many of the children considered their patterns of reacting, such as feeling unable to cope or becoming angry, as contributing to their getting headaches. CONCLUSIONS: The children related their headaches consistently to everyday situations and to their relations with others. This highlights the need for broadening the consultation in terms of including personal and contextual factors