Context:  Tension type headache is a painful and common symptom and is one of the most frequent causes of consultation in both general practice and neurological clinics. Objectives: The purpose of the study is to investigate the involvement of sympathetic nervous system in tension–type headache. Methods: The evaluation was done by standard, bedside, non–invasive tests like orthostatic test, cold pressor test and sustained hand grip test. ­­­­­Results: In the present study the basal heart rate was significantly decreased in tension type headache patients as compared to healthy controls. Also sympathetic function as evaluated by the cold pressor and sustained hand grip tests was found to be abnormal as compared to controls. Conclusion: We conclude that sympathetic dysfunction was present in Tension type headache.