Nausea is a common symptom, and vomiting is a common sign of a variety of medical conditions or physiologic phenomena. Nausea and/or vomiting can lead to significant patient anxiety and distress. Furthermore, excessive vomiting can lead to dehydration and subsequent electrolyte, metabolic, and hemodynamic concerns. Common causes of nausea and/or vomiting seen in practice include gastroenteritis, motion sickness, pregnancy, and as an adverse effect of medications. These are often self-limiting. However, more serious causes can include intracranial, gastrointestinal, genitourinary, cardiac, or metabolic disorders. In these cases, appropriate investigations must not be delayed as prompt treatment of the underlying cause is essential. Pharmacist assessment of the patient presenting with nausea and/or vomiting requires consideration of additional symptoms, the patient’s history, details of the nausea and/or vomiting itself, and patient-specific factors using a systematic approach. The pharmacist must be aware of the features that can indicate a potentially serious, and sometimes life-threatening, cause (red flag) as these patients require urgent referral to emergency care. In the absence of red flags, pharmacists can use the information gathered in the assessment process to determine the likely reason(s) for nausea and/or vomiting and provide guidance on non-pharmacologic and/or pharmacologic management strategies. Ongoing monitoring of patients with nausea and/or vomiting is important to ensure optimal symptom management, prevention or correction of dehydration, and resolution of the underlying cause.