Introduction: Tension-type headache is the most common type of headache across the world. Saliva as a non-invasive medium is used to detect a wide range of diseases. Salivary Alpha-Amylase (SAA) levels has been suggested as a potential indirect marker for detecting Sympathoadrenal Medullary (SAM) activity, which is activated by pain. Significant correlation was found between SAA levels and pain scale in patients with chronic pain. The purpose of the present study was to measure SAA activity in Frequent Episodic Tension-Type Headache (FETTH). In addition to the Visual Analogue Scale (VAS), we intend to assess intensity and various aspects of pain by McGill Pain Questionnaire (MPQ). 
Methods:  A total of 45 females with FETTH (case group) and 45 healthy voluntary females (control group) were enrolled in our case-control study. Unstimulated saliva by spitting method was taken from each participant. 
Results: SAA levels were significantly higher in patients with FETTH (P<0.001) when compared with the control group. There was significant correlation between SAA activity and MPQ score (P<0.001).
Conclusion: This is the first study using MPQ as a subjective means of assessing quality and quantity of pain alongside the VAS as an objective tool for evaluating pain in patients with FETTH. SAA may be an appropriate marker for assessing of pain levels in patients with FETTH. MPQ versus the VAS may be a more accurate measurement tools along VAS.