Nausea and vomiting are considered as two of the most distressing side effects of chemotherapy. The frequency of nausea and vomiting depends primarily on the emetogenic potential of the chemotherapeutic agents used. With the introduction of the neurokinin-1-receptor-antagonists in combination with 5-HT(3) receptor-antagonists and steroid approximately 70-90 % of patients receiving highly emetogenic chemotherapy can be protected from emesis. Here, the most recent developments in the antiemetic therapy including the latest guidelines for antiemetic prophylaxis are described.