BACKGROUND: Recurrent headaches in headache disorders adversely impact quality of life and job. Migraines and tension-type headache TTH) are the most common primary headaches and a prominent cause of disability globally. However, few research compare headache illness burden in China, India, the United States (US), and Japan. METHODS: Global and Chinese, the US, Indian, and Japanese migraine and TTH incidence, prevalence, and disability-adjusted life years were taken from the GBD database for 1990-2021. The data is studied utilizing decomposition analysis, health inequality research, joinpoint regression model, and Bayesian Average Annual Percentage Change (BAPC) model. RESULTS: The study found that migraine mostly affects women aged 15-49, while TTH are evenly distributed across gender and age. The worldwide average annual percentage change (AAPC) in disease-adjusted life years (DALYs) for migraine and TTH from 1990 to 2021 was 0.0357, a statistically significant trend ( CONCLUSION: Globally and in China, migraine and TTH incidence and burden have increased since 1990. Migraines are becoming more common in young and middle-aged women, so headache treatment professionals should invest more in patient education to raise awareness and improve self-management to reduce disease burden and medical costs.