Objective <p>Anticipatory nausea and vomiting can impose a significant physical and psychological burden on children and their families, but the risk factors for the development of anticipatory nausea and vomiting in children receiving chemotherapy are unclear. The aim of this study was to investigate the risk factors for anticipatory nausea and vomiting in children receiving chemotherapy, to provide a basis for medical personnel to formulate a pre-chemotherapy anti-vomiting program, to reduce the discomfort experience of children undergoing chemotherapy, and to improve the quality of life.</p> Methods <p>A prospective cohort study using the Baxter Facial Scale and the Department of Health and Human Services Vomiting Severity was conducted to collect risk factors for anticipatory nausea and vomiting in children receiving chemotherapy at a tertiary-level children’s hospital in China in 2022, and logistic regression analysis was performed.</p> Findings <p>Of the 378 children with chemotherapy, 155 (41.01%) had anticipatory nausea and 40 (10.58%) had anticipatory vomiting. Logistic regression analysis showed that negative emotions and concomitant discomfort are independent risk factors for anticipatory nausea in children undergoing chemotherapy (<i>P</i> &lt; 0.05); negative emotions, concomitant discomfort, and history of CINV are independent risk factors for anticipatory vomiting in children undergoing chemotherapy(<i>P</i> &lt; 0.05).</p>