We evaluated whether or not routine prophylaxis with 2.5 mg of droperidol would efficiently prevent postoperative nausea and vomiting (PONV). Fifty-two patients scheduled for elective gynecological laparoscopic surgery were eligible for this study. Anesthesia was induced using propofol, fentanyl, and vecuronium, and maintained with sevoflurane in nitrous oxide, fentanyl, and vecuronium. Patients were randomized to one of two groups: group 1 patients (n = 23) received 2.5 mg droperidol intravenously when the surgery was started, while group 2 patients (n = 29) did not receive any droperidol. At the conclusion of the surgery, the patient was extubated on satisfactory emergence from general anesthesia. Any episodes of nausea and vomiting, rescue medications, and adverse effects were recorded until the next morning after the surgery. There were no differences in the duration of anesthesia on surgery between the groups, but the total fentanyl dose in group 1 was higher than that in group 2. Episodes of nausea and vomiting and the need for metoclopramide in group 1 were lower than in group 2, though the total fentanyl dose in group 1 was higher than in group 2. There were no differences in the need for analgesics between the groups. The use of 2.5 mg droperidol safely decreased PONV after gynecological laparoscopy.