Migraine attacks are usually divided into a prodromal phase, an aura phase, a headache phase, and a postdromal phase. Prodromal symptoms are redefined in the International Classification of the Headache Disorders, 3rd edition (ICHD-3) in 2018. Over the past three decades, numerous clinical studies have focused on the incidence and common phenotypes of prodromal symptoms in adults and children. The existing evidence of nerve electrophysiology and functional imaging suggest that the activation of the hypothalamus and the change of pain modulation pathway are closely related to the development of prodromal symptoms, in which periaqueductal gray (PAG)-rostral ventromedial medulla (RVM)-trigeminal spinal nucleus (SpV) pathway plays an important role. So far, there are no large randomized controlled trials to verify whether prodromal administration can effectively prevent pain attacks. It is beneficial to identify prodromal symptoms as early as possible and take measures to reduce the burden of headaches and even prevent migraine attacks. This review focuses on the prevalence, clinical phenotype, differences between a trigger and an aura, and possible pathophysiological mechanisms of prodromal symptoms, hoping to guide the prevention and management of migraine prodromes in the future.