Objective <p>To evaluate the efficacy of different periods for the prevention of postoperative nausea and vomiting (PONV) in patients undergoing gynecological laparoscopy with transcutaneous electrical acupoint stimulation (TEAS).</p> Design <p>Prospective, randomized, double-blind trial.</p> Setting <p>An academic medical canter specializing in the care of women and children.</p> Population or sample <p>A total of 120 women were enrolled.</p> Methods <p>Patients were randomly allocated to three groups: a single-period TEAS group (Group S, <i>n</i> = 40), a multi-period TEAS group (Group M, <i>n</i> = 40) and a non-stimulation control group (Group C, <i>n</i> = 40). TEAS was applied at specific acupuncture points preoperatively and postoperatively.</p> Main outcome measures <p>The primary outcome was the incidence and severity of PONV during the 48&#xa0;h after surgery and the secondary outcomes included pain, early recovery after surgery, and complication.</p> Results <p>Within postoperative 0–2&#xa0;h, 4–12&#xa0;h, group M had less frequency and lower scores for nausea compared with group C and group S had only less frequency of nausea compared with group C at 4–12&#xa0;h postoperatively. The frequency and severity of vomiting for group M were less than group S in the postoperative 2–4&#xa0;h. Group M mitigated pain and reduced the rescue antiemetic compared to group S.</p> Conclusion <p>Multiple-period TEAS provides greater efficacy and a longer duration of action than single-period TEAS. It effectively reduces PONV in patients undergoing gynecological laparoscopic surgery which could be a new option in multimodal prophylactic antiemetic regimes for perioperative undergoing gynecological laparoscopic surgery.</p> Trial registration <p>Chinese Clinical Trials Registry, No. ChiCTR2200065802, Registered 15/11/2022. https//www.chictr.org.cn/bin/project/edit? pid=175,377.</p>