This review article cites as its basis ‘The Consensus Guidelines for Managing Postoperative Nausea and Vomiting’, an international panel of experts’ evidence-based opinions, and the IMPACT Study. The pathophysiology, risk factors, and strategies for reducing postoperative nausea and vomiting (POVN) are concisely highlighted. Female gender, non-smoking status, history of POVN or motion sickness, and postoperative opioid use are the simplified risk factors. Risk factors are then translated into a management strategy for the different at-risk groups. The article discusses approaches to reduce the risk of POVN, prophylaxis against POVN in high-risk groups, and treatment options if it occurs. The stratified approach provides an excellent basis for a discussion with your anaesthetist about how the care of your patients can be realigned, particularly if you have negative feedback on this issue. The article is primarily written for the North American reader but I would consider it straightforward to apply in the European context.