Clinical research has demonstrated that large numbers of chemotherapy patients continue to experience nausea in the clinic prior to infusions. A better understanding of the mechanisms responsible for such anticipatory nausea (AN) is likely to provide critical information for identifying intervention targets. In the present study the authors investigated the contribution of expectancy, history of nausea, and distress to AN in 60 women with Stage I or II breast cancer receiving standard adjuvant chemotherapy. The predictors were each independently associated with AN (p < .05). However, only expectations significantly predicted AN in simultaneous regression analyses. Results suggest that interventions to reduce AN during chemotherapy should target patients' expectations.