The present report describes the effect of intra-arterial injection of a dose of 40 mg lidocaine and 20 mg methylprednisolone into the middle meningeal artery of two patients suffering from severe headaches. The effect of injection of lidocaine and methylprednisolone was short lasting with effect manifesting within 5 min and lasting 5–8 h after injection. Both patients reported improvement in headache intensity after 24 h post-procedure. Intra-arterial injection of lidocaine and methylprednisolone may represent another treatment strategy for headaches not responsive to standard treatment.