Postoperative vomiting (PV) is a complication of surgery under general mainly anaesthesia. Nowadays about 1 in 3 surgical patients complain of PV. The aetiology of PV is multimodal and so must be the management. There are simple methods to predict the patients who will vomit postoperatively and these patients must be managed with special measures, preferably before PV will be established. Aetiology, prediction and management of high risk for PV patients are analyzed and discussed.