The thalamus, one of the most important integrative structures of the brain, plays a significant role in the pathogenesis of migraine, which affects approximately 10–20% of the global population and is characterized by headache. In migraine, phonophobia, defined as increased sensitivity to sounds that are normally not disturbing, is observed in 70–80% of attacks. The medial geniculate body (MGB), one of the thalamic nuclei, is responsible for transmitting auditory stimuli to the primary auditory cortex and also plays a role in the regulation of auditory perception. The aim of this study was to evaluate the volume and volumetric asymmetry of the medial geniculate body in female patients diagnosed with migraine and to compare the findings with healthy individuals. A total of 51 female migraine patients aged 18–64 years and 51 healthy females aged 18–66 years were included in the study. Cranial magnetic resonance images of the participants were obtained from the hospital PACS system and analyzed using VolBrain software. Right, left, and total MGB volumes, as well as asymmetry ratios, were calculated, and statistical analyses were performed using IBM SPSS Statistics version 25. Independent samples t-test was used for group comparisons, and Pearson correlation analysis was applied to evaluate the relationship between age and volume and asymmetry. The findings showed that there was no statistically significant difference between migraine patients and the healthy control group in terms of right, left, and total MGB volumes and volumetric asymmetry (p > 0.05). In addition, no significant relationship was found between age and MGB volume and asymmetry values (p > 0.05). In conclusion, migraine does not have a significant effect on MGB volume and volumetric asymmetry; moreover, phonophobia may be associated with functional or network-level mechanisms rather than macrostructural changes.