Background: Postoperative nausea and vomiting (PONV) remains a troublesome problem. This study was performed to evaluate the antiemetic efficacy of prophylactic granisetron, a selective 5-hydroxytryptamine type 3 receptor antagonist, on the incidence of PONV in patients undergoing general anaesthesia for breast surgery. Methods: In a randomized, placebo-controlled, double-blind study, 50 female patients, 45-68 years, were given a single dose of either placebo (saline, n=25) or granisetron (40 mu g.kg(-1), n=25) intravenously over 2-5 min immediately before the induction of anaesthesia. Postoperatively during the first 24 hours after anaesthesia, the incidence of PONV and adverse events was recorded. Results: The treatment groups were similar for patient demographics, types of surgery, anaesthetic and postoperative management. Postoperatively: the incidence of PONV was 48% and 16% after administration of placebo and granisetron, respectively (P<0.05). No differences in the incidence of other adverse events were observed between the two groups. Conclusion: Granisetron is an effective antiemetic for preventing PONV in patients undergoing general anaesthesia for breast surgery.