This article presents a review of current findings related to neurovestibular physiology, aetiology, and proposed theories on space motion sickness (SMS) during acute and sustained exposure to microgravity. The review discusses available treatment including medication and non-pharmacological countermeasure methods that help prevent the development of SMS in weightlessness. Ground-based simulations using virtual reality, flight simulations and Barany's chairs can be applied to study SMS and demonstrate its signs and symptoms to space crew members. Space motion sickness has been observed in approximately 70% of astronauts within the first 72h in microgravity, having in general an instantaneous onset of signs and symptoms. Stomach discomfort, nausea, vomiting, pallor, cold sweating, salivation, tachypnoea, belching, fatigue, drowsiness and stress hormone release have been documented. This can have detrimental effects on the well-being of astronauts in the initial phase of a space mission. Mental and physical performance may be affected, jeopardizing operational procedures and mission safety.

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