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Introduction/Background: Effective antiemetic treatment is essential in reducing postoperative nausea and vomiting (PONV), but the clinical implication of PONV increases the length of hospital stay and healthcare resource utilization. In patients undergoing laparoscopy surgery, there is an increased incidence of PONV due to inhaled anesthetics, abdominal insufflation of carbon dioxide, and patient positioning. PONV refers to the presence of nausea, vomiting, or retching within 24 hours during the postoperative period following surgery. PONV affects roughly 35% of all surgical patients, and the risk increases up to 80% in patients with risk factors.1 The Apfel Simplified Risk Score, developed in 1999, provides a tool that guides risk stratification based on known factors that contribute to increased risk of PONV: these factors include female sex, non-smoking status, history of PONV or motion sickness, and use of postoperative opioids.2-4 Despite attempts to prevent untoward outcomes via a multidisciplinary approach, the incidence of PONV continues to ensue. Perioperative management of PONV using risk factor criteria helps streamline patient treatment options. Addressing PONV during the perioperative period by administering medications with antiemetic properties may reduce the incidence in susceptible patients. Treatment for PONV utilizes a multifactorial approach including serotonin receptors (5-HT3) such as ondansetron, dopamine receptor antagonists such as metoclopramide, anticholinergics such as scopolamine, corticosteroids such as dexamethasone, and neurokinin-1 receptors such as aprepitant. Dexmedetomidine (DEX) is an alpha-2 agonist with multimodal effects, and there is growing clinical research on its use to reduce PONV. It has sedative, anxiolytic, hypnotic, analgesic, and sympatholytic properties without causing significant hemodynamic instability and maintains respiratory drive.