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Cancer chemotherapy might in turn induce nausea and vomiting as a side effect, which impairs patients’ quality of life and adherence to medications. Inconsistent following of antiemetic guidelines among the physician could significantly increase the incidence of chemotherapy-induced nausea and vomiting in cancer patients. This study was aimed to evaluate antiemetic guidelines consistency and the effectiveness of antiemetics in controlling chemotherapy-induced nausea and vomiting in cancer patients. This study was carried out among patients treated with low emetogenic chemotherapy to highly emetogenic chemotherapy who had completed their first chemotherapy cycle at the department of Haemato-Oncology. Among the 1725 adult patients enrolled in the study, only 60 % received cancer medications according to the standard guidelines and 40 % did not. Fifty-two percent patients were under highly emetogenic chemotherapy regimen, 36 % were in moderate emetogenic chemotherapy and 12 % in low emetogenic chemotherapy regimen. Antiemetic drug was given adjunct to cancer chemotherapy, in which 82 % of patients were found to have no emesis in all highly emetogenic chemotherapy, moderate emetogenic chemotherapy and low emetogenic chemotherapy cohorts while 8.35 % with acute, 7.65 % with delayed, 2.32 % with acute and delayed emesis were observed in highly emetogenic chemotherapy cohort. A 10 % failure rate was observed in the treatment groups even though the guidelines were followed to treat chemotherapy-induced nausea and vomiting. In addition to implementing anticancer treatment guidelines, strict monitoring of patients and follow up is very essential to prevent treatment failure in chemotherapy-induced nausea and vomiting.