〔Abstract〕 Objective To analyze the effect of transcranial Doppler (TCD) bubble test combined with contrast-transthoracic echocardiography (cTTE) of right heart in the diagnosis of migraine complicated with patent foramen ovale (PFO) in young and middle-aged patients. Methods A total of 159 young and middle-aged patients with migraine treated in the First People's Hospital of Shangqiu from January 2020 to June 2022 were selected. TCD bubble test, cTTE of right heart and trans esophageal echocardiography (TEE) were performed in all patients, and TEE diagnostic result as the standood. To evaluate the diagnostic efficacy of TCD bubble test, cTTE of right heart and the combination of the two methods. Results TEE diagnosed 56 patients with migraine complicated with PFO, 103 patients with migraine alone. 42 migraine patients complicated with PFO were detected by cTTE of right heart, 48 cases by TCD bubble test, and 54 cases by TCD bubble test combined with cTTE of right heart. The sensitivity and specificity of TCD bubble test combined with cTTE of right heart in the diagnosis of migraine with PFO were higher than that of cTTE of right heart and TCD bubble test alone. The sensitivity of TCD bubble test was higher than that of cTTE of right heart, but its specificity was lower than that of cTTE of right heart. Conclusion TCD bubble test combined with cTTE of right heart can provide a more accurate reference for the diagnosis of migraine complicated with patent foramen ovale in young and middle-aged patients.