Migraine headache is one of the leading 10 causes of disability and causes significant impairment in daily functioning as well as socio-occupation functioning. Despite being significantly high in prevalence rates and having a negative impact on quality of life it continues to be under diagnosed and undertreated. Around a third of the population presents with an aura that may include ill-formed hallucinations- zigzag lines, crescent and non-linear patterns that are rarely fully formed. We report a rare presentation of a patient with formed visual hallucinations which was difficult to diagnose due to various neuropsychiatric differentials. After extensive evaluation and neuro-imaging to rule out other medical, neurological and psychiatric causes patient was started with management for migraine on which a good response was seen. Formed visual hallucinations are rare presentation in classic migraine but more complex hallucinations can occur in migraine coma and familial hemiplegic migraine. Our patient was diagnosed to be a case of Classic migraine with visual hallucinations having a score of 78 on HIT-6 (Headache Impact Test-6) and severe disability with a score of 78 on MIDAS (Migraine Disability Assessment). Subsequently, on treatment optimization withTablet Propranolol- 80 mg and Tablet Flunarizine- 10mg per day a good response (HIT-6 score = 36) was seen over the next 6 weeks. Hence, the index case after careful assessment and extensive evaluation was diagnosed to be a rare case of Classic migraine with aura (formed visual hallucinations) and showed a good response to treatment with Propranolol and Flunarizine.