This report describes a case of cluster headaches that was successfully treated with Senkito. The patient was a 46-year-old female. She had been having attacks of cluster headaches that had continued for 3 days at the change of seasons since she was 30 years old. During an attack, she took a triptan preparation and non-steroid anti-inflammatory drug (NSAID), but they were not effective. Recently, the attacks had been increasing in frequency and continued for 1-2 weeks. She visited our hospital for Kampo treatment. We diagnosed her as having oketsu and kiutsu ; therefore, we prescribed tsudosan, and the frequency and strength of the attacks decreased. Even if NSAIDs were effective for headaches, they were not consistently effective. We re-examined her and found she had inside biryokotsu, which is tenderness in the orbital part of the frontal bone. We diagnosed her headache as including biryokotsu pain. We prescribed Senkito as required for her biryokotsu pain. It was very effective and the headache vanished after only 30 min. Generally, the potency of Kampo medicines with few structural components is higher than that of those with many structural components. Senkito has only five structural components ; therefore, we concluded that Senkito is effective not only for everyday use but also for use when required. Senkito is one of the most effective formulations for treatment of biryokotsu pain,especially the patient with inside of biryokotsu tenderness.