Aim: Many patients suffer from acute and chronic resistant headache after suboccipital craniectomies. Many studies conclude that replacement of the bone flap has an important role in decreasing the severity of postcraniotomy headaches (PCH). These studies were performed in supratentorial and retro-sigmoid craniotomies. However, no comparative studies were performed in patients who underwent standard suboccipital craniotomy. In this study, we compared the severity of PCH between patients after craniectomy versus craniotomy.