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Background and purpose: Chemotherapy-induced nausea and vomiting (CINV) can cause severe damage to body functions and even lead to death. The prevention of CINV is critically important in patients receiving emetogenic chemotherapy regimen. This study aimed to investigate the prevalence and treatment of CINV in Grade-A tertiary hospitals in Shanghai and explore risk factors of CINV to improve its management. Methods: The clinical data of 376 cancer patients in Grade-A tertiary hospitals in Shanghai from October 2022 to December 2022 were collected retrospectively. The questionnaire was used to conduct a crosssectional study. The univariate and multivariable logistic regression models were used to evaluate the influencing factors of CINV. Results: The management and coincidence of the guideline in 2022 significantly improved compared to five years ago. For patients receiving high-emetic-risk chemotherapy regimen, the coincidence of the guideline increased from 21.6% to 67.0%. For patients receiving moderate-emetic-risk chemotherapy regimen, the neurokinin-1 (NK-1) receptor antagonist was not significantly associated with CINV. Multivariable analysis showed that the chemotherapy regimen was the only risk factor for CINV during the whole period (P＜0.05). Conclusion: The chemotherapy regimen is the main risk factor for CINV. To control CINV better, clinical practitioners should focus on the intrinsic risk of chemotherapy regimens preferentially, estimate the risk and adhere better to guidelines. [ABSTRACT FROM AUTHOR]