Abstract. This study analyzed the principal trigger factors and clinical course of Call-Fleming syndrome in a local cohort. The study included 30 consecutive patients observed in the 1st and 2nd Neurology Departments of the Andijan State Medical Institute Clinic from October 2023 to December 2025. The design was prospective, single-center, and observational. Clinical, anamnestic, neurological, and neuroimaging data were evaluated systematically. Women predominated in the cohort: 23 of 30 patients (76.7%) were female, and 9 patients (30.0%) were in the postpartum period. The mean age was 38.6±9.4 years. Thunderclap headache was the leading clinical sign and was recorded in 29 patients (96.7%), while recurrent thunderclap attacks were documented in 27 patients (90.0%). A headache-dominant phenotype was observed in 18 cases (60.0%), a focal neurological phenotype in 7 cases (23.3%), and a complicated phenotype in 5 cases (16.7%). The most frequent triggers were vasoactive or serotonergic drugs in 12 patients (40.0%) and postpartum or hormonal factors in 9 patients (30.0%). Emotional stress and physical exertion were each identified in 5 patients (16.67%), while Valsalva-related situations or sexual activity were found in 4 cases (13.33%). Multiple triggers were present in 6 patients (20.0%), supporting the multifactorial nature of the syndrome. In this local cohort, Call-Fleming syndrome most often affected women of reproductive age and was characterized by recurrent thunderclap headache, frequent drug-related and postpartum triggers, and clinically heterogeneous presentation.