Adam presented at the age of 6 years with recurrent episodes of intense nausea, vomiting, sleepiness and pallor. His parents report that these episodes began at around the age of 3 years, occurring two to three times per year, and increased in frequency over the past 2 years to six to eight times per year. The typical episode starts with feeling unwell, looking pale, refusing normal meals and complaining of nausea, abdominal discomfort and lethargy. Within an hour or two, he starts to vomit repeatedly, which makes him unable to leave his bed. The episodes typically resolve within 24–48 h, with a complete return to normal health following each episode. Over the past 2 years, he was admitted to the hospital on several occasions because of suspected or confirmed dehydration and was given intravenous fluids. The physical examination revealed no abnormal findings, with no fever or signs of infection. Investigations revealed a normal blood count, normal inflammatory markers, normal blood tests for electrolytes, urea, creatinine, liver function tests, and glucose, as well as a negative screen for celiac disease. No evidence of infection on throat swabs and urine culture. He also had a normal metabolic screen and upper gastrointestinal endoscopy. A diagnosis of cyclical vomiting syndrome was made, and plans for management of acute episodes and preventive treatment were made.