Nausea and vomiting are common symptoms in daily clinical practice. For appropriate diagnostics the knowledge of the pathopysiologic origin of nausea and vomiting is indispensable. Furthermore the diagnostic pathway usually has to be approached by an interdisciplinary team. Due to the broad spectrum of emetogenic causes several symptom-based treatment strategies are nowadays available. These include several kinds of antiemetics with different mechanisms of action and with an varying antiemetic potential. The antiemetic strategy is based on individual patient factors as well as on the receptor specific mechanism of action of the antiemetic drug and also the expected side effects. A number of modern antiemetic agents are available for the management of nausea and vomiting, including 5-HT(3)-receptor antagonists and NK(1) receptor antagonists. However, other conventional antiemetic drugs are still in use and should not be underestimated.