Migraine is a leading cause of disability and a frequent presentation in primary care, where traditional preventives such as topiramate and propranolol remain widely used despite tolerability issues and limited adherence. Advances in migraine science have introduced calcitonin gene–related peptide (CGRP)–targeted therapies, including the oral CGRP receptor antagonist atogepant. These emerging treatments offer improved safety and convenience, positioning them as potentially transformative options within primary care.To summarize recent evidence on emerging preventive migraine therapies, focusing on atogepant’s efficacy, safety, and clinical relevance, and to assess its potential role as a first-line option in primary care settings.This narrative review searched for studies (meta analysis and randomized controlled trials) published on PUBMED and ELSEVIER,between 2020 and 2025. Sample sizes ranged from 252 to over 14,000 participants. Extracted data included monthly migraine day (MMD) reduction, tolerability, patient-reported outcomes, and consistency across study designs.Randomized control trials demonstrated significant reductions in MMDs with atogepant in both chronic and episodic migraine, with a favorable tolerability profile. Meta-analyses confirmed its efficacy across doses and highlighted predominantly mild gastrointestinal side effects. Long-term studies reported sustained improvements in quality of life and functional outcomes. Indirect comparison analyses suggested greater MMD reductions with atogepant than with rimegepant, reinforcing its preventive potential. Network meta-analyses also placed atogepant among the most effective and best tolerated CGRP-targeted options.The evidence indicates that atogepant offers advantages over traditional preventives, including simplified dosing, no titration requirements, and fewer systemic adverse effects. These characteristics support improved adherence and suitability for primary care management. Although direct comparisons with topiramate or propranolol are lacking, current data suggest that gepants are particularly valuable for patients who have not responded to or tolerated older therapies. There is a lack of cost effectiveness studies which presents an opportunity at further research.CGRP-targeted therapies represent a significant advancement in migraine prevention. Evidence supports their effectiveness, tolerability, and clinical utility, making them strong candidates for incorporation into primary care migraine prevention strategies aimed at improving outcomes for individuals with migraine.