Abstract: Objective To analyze the clinical features of refractory medication overuse headache (MOH). Methods Clinical data about 31 patients with refractory MOH admitted to department of neurology in the first medical center of Chinese PLA General Hospital from June 2014 to June 2019 were collected and analyzed. Results Of the 31 patients with refractory MOH,there were 10 males (32.3%) and 21 females (67.7%) with an average age of 49.4±8.6 years.Twenty-three patients (74.2%) were complicated with anxiety,21 patients (66.7%) with depression,28 patients (90.3%) with insomnia.Migraine as primary headache was found in 25 patients (80.6%).Overuse of multiple drugs was found in 18 patients (58.1%),and overuse of compound analgesics in 28 patients (90.3%).There was significant difference between male patients and female patients in non-adherence of taking medication (100% vs 61.9%,P=0.023). Conclusion Refractory MOH is more common in middle-aged women,and it is prone to complicate with anxiety,depression and insomnia.Migraine is the most common primary headache in refractory MOH patients,with compound analgesic as the most commonly overused drug.Multiple drugs overuse is common in patients with refractory MOH.