Post-operative nausea and vomiting (PONV) is a very common problem that not only reduces patient satisfaction and comfort, but it also lengthens PACU stays and increases admissions to the hospital. One of the first ways to treat PONV is to anticipate it as a potential problem and to choose a different anesthetic plan. Regional anesthesia is the least associated with PONV while total intravenous anesthetics are next least associated. Long cases with opiates and volatile anesthetics are more commonly associated with PONV. Treatment for PONV is considered preventive before the patient experiences nausea and considered rescue therapy after the nausea has begun.