Perioperative nausea and vomiting (PONV) is associated with patient distress and prolonged hospital stay. A good understanding of the risk factors and methods for prevention of PONV empower urologists to improve the patient’s experience of surgery and reduce complications such as wound dehiscence and aspiration which can result in significant morbidity. This chapter focuses on the risk factors for PONV and the commonly used methods and anti-emetic medications for prevention and treatment.