Although both cyclic vomiting syndrome (CVS) and cannabinoid hyperemesis syndrome (CHS) are chronic conditions, affected patients often present to emergency departments (EDs) for care of severe episodes of nausea, vomiting, and abdominal pain. ED management protocols address dehydration, energy depletion, gastrointestinal symptoms, associated comorbid conditions (migraines, anxiety, hypertension), and possible confounding cannabis use. Consequently, CVS patients are offered intravenous (IV) hydration, antiemetic treatments, pain control, and sedation as needed in the ED. In addition to recommendations to abstain from cannabis use, CHS patients may be provided specific therapies, including topical capsaicin or IV haloperidol. Goals of ED management are to deliver a personalized treatment plan which is implemented by the ED team, comprising physicians, nurses, receptionists, and patient advocates. The best health systems employ automatic alerts for individual CVS and CHS patients to ensure predictable and effective care.