Summary This study documents the age‐related incidence of vomiting in paediatric patients following strabismus surgery under a postoperative policy of delayed oral alimentation (3‐6 h), minimized motion and the avoidance of anti‐emetic medications. The incidence of vomiting prior to discharge was 4%. The average time from completion of surgery to discharge home was 84 min. The overall incidence of vomiting in the 24 h following surgery was 43%; almost half of this incidence occurred during the car ride home. Children 3 years of age or older were twice as likely to vomit than those younger than 3 years of age. A literature review finds that no drug has been shown by independent investigators to decrease consistently the incidence of vomiting following strabismus surgery. For most drugs, anti‐emetic efficacy parallels the degree of sedation and prolongs recovery; once the sedative effects have abated, the incidence of vomiting approaches that in untreated patients. Our protocol allows for early discharge with the same expected incidence of post‐discharge vomiting as reported for children receiving pharmacologic anti‐emetic prophylaxis.