Overview: Although chemotherapy-induced nausea and vomiting is recognized as having been an important problem during the initial introduction of chemotherapy into the antineoplastic armamentarium, the assumption that this problem has already been solved can restrict optimal management and further advances. Underestimation of nausea and vomiting may have many causes. If these toxicities are assumed to be necessary properties of chemotherapy, then their incidence may be taken for granted. If nausea and vomiting appear after discharge from the clinic several days after chemotherapy, these toxicities may not be reported because of poor recall or because of efforts by patients to avoid unnecessary complaints. Physician education may be compromised if physicians see nausea and vomiting as population problems but not problems for their own patients. Failure to recognize nausea and vomiting as two distinct entities that may appear independently of each other can also limit understanding of the prevalence of these problems and efforts at effective management. Continued attention to the impact of nausea and vomiting on the patient experience will be necessary to insure optimal maintenance of quality of life.