Prevention of chemotherapy-induced nausea and vomiting (CINV) is crucial in maximizing patients' quality of life and optimizing outcomes of cancer therapy, and can be done more effectively than ever before. Appropriate antiemetic therapy combined with targeted patient education, clear communication, and management of patient expectations results in optimal emetogenic control. Oncology nurses play a critical role in the prevention and management of CINV. This column reviews the history and pathophysiology of treatments for CINV, as well as patient- and chemotherapy-specific risk factors that should be considered to optimize treatment outcomes in patients with CINV.