Postoperative nausea and vomiting (PNV) is a common disorder at the forefront of ambulatory care issues. New antiemetic drugs and improved anesthetic techniques have decreased the incidence of anesthesia-induced PNV. Patient characteristics and surgical factors are now largely responsible for postoperative emesis. Clinicians need to understand these factors to deal effectively with PNV as the use of ambulatory surgery increases. Physicians should consider both prophylactic drug intervention and direct treatment.