Urban telemedicine services have emerged as a promising solution to improve access to healthcare in underserved urban areas, particularly for chronic conditions such as migraine. A mixed-methods approach was employed, involving a structured questionnaire survey with both quantitative and qualitative components to gather data from participants who had utilised the telemedicine platform over six months. The findings indicate that patients reported an average improvement in headache frequency of 20% (SD = 5%) following their initial consultations. Patient satisfaction scores averaged 85/100, with a significant positive correlation observed between patient adherence to treatment plans and improved health outcomes. This study confirms the effectiveness of urban telemedicine services for managing migraine in Dar es Salaam, Tanzania, highlighting the potential for expanding such services to other underserved populations. Based on these findings, recommendations include further implementation of tailored follow-up care plans and enhanced patient education programmes to optimise treatment outcomes.