Abstract: OBJECTIVE To discuss the efficacy and safety of palonosetron to prevent elderly patients’ postoperative nausea and vomiting after lower abdominal surgery which used da Vinci Surgical System. METHODS Sixty?cases of elderly patients undergoing general anesthesia for lower abdominal surgery which used da Vinci Surgical System, ASA Ⅰ-Ⅱ, were randomly divided into 2 groups: treatment group and control group. The patients of treatment group were given palonosetron 0.25 mg and control group were given ondansetron 4 mg combined with dexamethasone 0.1 mg·kg^-1 by intravenous injection after 30 min in AICU. The number of nausea, vomitting and complete response rate(CRR) of the patients during 0-6?h, >6-12 h, >12-24 h and >24-48 h after surgery in 2 groups was recorded. Other related adverse effects were also noted. RESULTS The CRR between 2 groups had no statistical difference during 0-6 h, >6-12 h, >12-24 h after surgery. Compared with control group, the CRR during >24-48 h in treatment group was significantly lower than control group(P<0.05). CONCLUSION Prophylactic therapy with palonosetron is more effective than ondansetron combined with dexamethasone for prevention of elderly patients’ postoperative nausea and vomiting after lower abdominal surgery which used da Vinci Surgical System in 48 h, which provides a safe and effective compatibility program in clinical.