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58; P less then .001). Hospitalizations during which an opioid was administered had a longer length of stay (adjusted rate ratio, 1.48; P less then .001) and higher 30-day readmission rate (aOR, 1.96; P less then .001). By pediatric hospital, opioid administration ranged from 0% to 23.5% of migraine hospitalizations. Hospitals with higher opioid administration rates demonstrated higher adjusted readmission rates (P less then .001) and higher adjusted rates of return emergency department visits (P = .026). CONCLUSIONS Opioids continue t