Nausea and vomiting associated with cancer chemotherapy are experienced by 70%-80% of patients receiving chemotherapy and can result in significant morbidity. Chemotherapy-induced nausea and vomiting (CINV) adversely affects patient quality of life, often leading to poor compliance with the treatment regimen and serious metabolic complications. Several classes of antiemetic drugs are available to prevent or treat CINV. Older agents include phenothiazines, antihistamines, and corticosteroids. Serotonin (5-HT3) receptor antagonists became available in the 1990s for use in preventing CINV. Recently, the NK1 receptor antagonist aprepitant was introduced for use in combination therapy regimens. Despite this introduction of new and more effective antiemetic agents, emesis remains a significant complication of chemotherapy. Updated antiemetic guidelines were published in 2007 by the National Comprehensive Cancer Network and in 2006 by the American Society of Clinical Oncology. Updates for clinicians who treat patients with CINV are now available and are reviewed here. © 2007 Elsevier Inc. All rights reserved.