Despite considerable effort in evaluating antiemetic strategies and the development of a new antiemetic class, postoperative nausea and vomiting (PONV) remains one of the most common and distressing complications after surgery. PONV not only increases physical and psychological discomfort but also causes wound dehiscence, dehydration, and electrolyte imbalance, which leads to delayed recovery, prolonged hospital stays, and life-threatening aspiration. [12-13] Published evidence suggests that prophylactic administration of antiemetic drugs should be considered for patients with two or more PONV risk factors, such as the female gender, nonsmoking, and the use of postoperative opioids. [14-15] Hence based on these findings the present study was planned for Comparative Evaluation of Prevention of post-operative nausea and vomiting (PONV) by Using Ramosetron and Ondansetron in High Risk Cases. The present study was planned in Department of Anaesthesia and Critical Care, Shree Krishna Medical College and Hospital, Muzaffarpur, Bihar, India. The 25 cases enrolled in Group A received the Ramosetron 0.3 mg and the other 25 cases enrolled in Group B received ondansetron 8 mg. The study drugs were drawn in identical syringes with 4ml volume each, labelled ′antiemetic′ (ramosetron was diluted to 4 ml in normal saline) by a nurse who was not a part of the study and handed to the respective OT anaesthesiologist. The patient and investigators were blinded to the study medication. The data generated Ramosetron is a very effective, safe antiemetic in the prevention of PONV and preoperative prophylactic administration of single dose IV Ramosetron (0.3 mg) has better efficacy than single dose IV Ondansetron (8 mg) in reducing the incidence of PONV over 12 hours postoperative period.