Background: Abdominal surgeries are associated with an appreciably high rate of post-operative nausea, vomiting and pain due to the severity of the proinflammatory cytokine response arising from peritoneal trauma. This study was designed to study the efficacy of single pre-operative dose of dexamethasone in reducing the incidence of post-operative nausea, vomiting and pain after major abdominal surgeries.  Methods: The study was prospective, randomized and double blinded. 60 adult patients of either sex, scheduled for elective laparotomy from March 2012 to October 2013 were included in the study. Results: In this study 86.7% of patients in the saline group experienced nausea, whereas only 13.3% of patients in dexamethasone group experienced nausea. Chi square value is 32.67 and p value is<0.05. Among the patients who received dexamethasone only 10% experienced vomiting, where as in the saline group 33.3% developed vomiting. Chi square value is 4.812 and p value is 0.029. This is statistically significant as p value is<0.05. Among the patients who experienced very severe pain 100% were from the saline group, whereas none of the patients in dexamethasone group experienced very severe pain. Among the patients who experienced severe pain 85.7% belonged to saline group, and only 14.3% were from the dexamethasone group. The p value is<0.05.  Conclusions: It was found that single pre-operative dose of dexamethasone (8 mg) reduces post-operative nausea, vomiting, pain significantly after abdominal surgery.