Cluster headache (CH) is a rare trigeminal autonomic cephalalgia. Although its pathophysiology is not entirely understood, the hypothalamus and trigeminal nociceptive and autonomic pathways seem to play a key role in its pathology. In the majority of cases, CH begins at a young age and affects mainly men. This article presents a case of a 76-year-old woman with CH that developed at the age of 74. This is one of the first documented reports of CH with such atypical features from an epidemiologic point of view. A possibility of symptomatic cluster-like headache (CLH) attributed to cerebrovascular disease in the patient is also discussed. Keywords: age at onset, cluster headache, primary headache, secondary headache, trigeminal autonomic cephalalgia