Emesis is a common occurrence in newborns and infants. The causes are ubiquitous and unfortunately nonspecific. However, clues exist with respect to the timing of the onset of emesis as well as to its character. Emesis can be bilious or nonbilious, projectile or nonprojectile, and in some patients it is effortless. Newborns and infants with emesis of gastric origin may display a paucity of visible external signs. Ultrasound, contrast radiographic studies, and endoscopy coupled with physical examination are invaluable in the assessment of the emesis. Important in the management is prompt correction of fluid and electrolyte losses. Surgical correction, if warranted, can then be undertaken with significant lessening of morbidity.