Migraine with aura is a type of migraine that is characterized by a warning sign, or an "aura," that a migraine attack is going to happen. The aura of migraine is usually visual in the vast majority of cases, because dysfunction starts from the visual cortex). The aura is usually followed, after a time varying from minutes to an hour, by the migraine headache. However, the migraine aura can manifest itself in isolation, that is, without being followed by headache). The aura can stay for the duration of the migraine; depending on the type of aura, it can leave the person disoriented and confused). It is common for people with migraines to experience more than one type of aura during the migraine). Most people who have auras have the same type of aura every time). Auras can also be confused with sudden onset of panic, panic attacks or anxiety attacks, which creates difficulties in diagnosis). The differential diagnosis of patients who experience symptoms of paresthesias, derealization, dizziness, chest pain, tremors, and palpitations can be quite challenging).

The warning sign of migraine with aura is most commonly a symptom that affects the sight, such as blind spots or seeing flashing lights. Auras can either happen on their own or together with the symptoms of a migraine without aura. The auras usually happen before a headache, which could be severe or mild. In some people, the headache may not happen. Auras usually start happening gradually over about five minutes and last for up to an hour. Other symptoms of aura can include numbness or tingling sensation like pins and needles in parts of the body, muscle weakness, and speech difficulties.

The exact causes of migraine aura are unknown, but research indicates that the condition may be due to an electrical wave that moves across the visual cortex, resulting in visual changes. Scientists have also looked into it and found that it may be caused by a slow wave of altered brain activity called "cortical spreading depression". This leads to temporary changes in the chemicals, nerves, and blood flow in the brain that affect how it works and could be related to pain.