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Eligible studies included clinical trials and observational studies assessing the efficacy and safety of US-GONB in migraine patients. Two reviewers independently performed data extraction and risk of bias assessment. Meta-analyses utilized RevMan 5.4, reporting mean differences (MD) with 95% confidence intervals (CI), applying random- or fixed-effects models based on heterogeneity.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Six studies (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u2009344) were included: four randomized controlled trials (RCTs), one non-RCT, and one retrospective cohort. Compared to sham, US-GONB significantly reduced pain intensity (MD: \u20133.57 points, 95% CI: [\u20133.95, \u20133.19]), monthly headache days (MD: \u201312.12\u00a0days, 95% CI: [\u201313.95, \u201310.29]), and analgesic use (MD: \u20132.05 analgesics, 95% CI: [\u20132.48, \u20131.62]). Efficacy relative to PRF was comparable; outcomes improved when PRF was added. SPG often showed superior results in head-to-head comparisons. Dizziness was the most frequent adverse event (38.9%), with serious complications being rare.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>US-GONB may be a well-tolerated, minimally invasive treatment for chronic migraine, particularly when pharmacologic strategies fail. It offers clinically meaningful improvements over sham but shows variable efficacy against active comparators. Some studies indicate potential synergistic effects with PRF. 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