Headache is common in childhood and can be associated with disability and distress. Family history of chronic pain may increase risk for pain and disability in childhood, although prior research has primarily focused on non-headache pain populations. We aimed to characterize the prevalence of headache, abdominal pain, and musculoskeletal pain in first- and second-degree relatives of youth with headache and determine whether family and parental pain history is associated with children’s headache experiences. We hypothesized that a positive family pain history would be common, and that greater extent of family and parental pain history would be associated with greater headache frequency, intensity, and disability. We enrolled 239 youth (Mage = 14.7, 66.5% female) with headache and their parents. Parents reported whether they and 16 of their first- and second-degree relatives had a history of migraine, tension-type headache, abdominal pain, or musculoskeletal pain. Youth completed a 28-day headache diary to assess headache frequency and pain intensity and completed the PedMIDAS, a measure that assesses headache-related disability. As expected, a family pain history was common: 65.7% of youth had a relative with migraine, 39.3% had a relative with tension-type headache, 44.8% had a relative with abdominal pain, and 66.9% had a relative with musculoskeletal pain. Children’s headache frequency was positively associated with the number of first- and second- degree relatives with a history of tension-type headache (r=.14, p=.04) and musculoskeletal pain (r=.14, p=.04), but not migraine or abdominal pain. We found that youth had greater disability when both parents had a history of headache compared to only one parent with a positive history, F(2,222)=3.27, p=.04. No associations were detected between family history and youth’s pain intensity. Our findings indicate children’s adaptation to headache may be influenced by their family. Further research is needed to understand potential mechanisms of intergenerational transmission of headache.