Chemotherapy-induced nausea and vomiting is a common adverse effect in cancer patients that not only impacts quality of life, but also treatment outcomes. The prevalence of nausea and vomiting is related to several factors, including the emetogenicity of the chemotherapy regimen, the dose and rate of administration of the chemotherapy agents, various environmental triggers and patient-related factors. The pathogenesis involves multiple organ systems, central nervous system, gastrointestinal tract and neurotransmitters. Clinical management should include a complete assessment of nausea and vomiting to investigate the possible etiology and the pharmacologic approach should involve agents that target each of these pathways and neurotransmitters. Various national guidelines provide recommendations for the prevention and management of CINV and combining these evidence-based strategies into clinical practice is crucial l to improve morbidity and quality-of-life outcomes among cancer patients.