This systematic review and meta-analysis evaluates the efficacy and safety of various preventive treatments for episodic migraine, focusing on options available in Mexico. The research synthesizes findings from randomized controlled trials (RCTs), categorizing treatments into pharmacological (like anti-CGRP monoclonal antibodies, gepants, and traditional medications) and non-pharmacological approaches (such as neuromodulation and acupuncture). The primary objective was to assess the impact of these interventions on monthly migraine days (MMD), monthly headache days (MHD), and acute medication days (AMD), alongside adverse events (AE). While CGRP-targeted therapies and gepants showed the most consistent reduction in MMD with favorable tolerability, traditional agents had more modest effects and higher adverse event rates. Non-pharmacological methods demonstrated promise but often lacked standardized reporting, highlighting the need for individualized, multimodal treatment strategies.