This study reviews 71 patients who presented between 1968 and 1988 with recurrent, self-limited episodes of nausea and vomiting separated by symptom-free intervals and were diagnosed with cyclic vomiting syndrome (CVS). The length and symptomatology of episodes tended to be stereotyped and characteristic for each patient over time. The disorder may persist from months to decades. There is a coincident relationship between CVS, migraine, and irritable bowel syndrome. The differential diagnosis includes many diseases which may mimic CVS. Management involves a responsive, collaborative doctor-patient relationship, sensitivity to stresses caused by the illness and to feelings and attitudes that may predispose to attacks, use of antiemetic agents to abort or shorten attacks, treatment of complications, and use of prophylactic agents in patients whose episodes are of sufficient frequency and severity to warrant their trial.