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To evaluate the effect of needling at acupuncture point Pericardium 6 on hydromorphone-induced nausea and vomiting.Randomized controlled clinical study.Eighty-one mixed-breed, healthy dogs aged 1.8 ± 1.6 years and weighing 14.5 ± 5.6 kg, admitted for elective ovariohysterectomy (n = 75) or castration (n = 6).Dogs were randomly assigned to one of three groups: acupuncture at Pericardium 6 (AT, n = 27); alternative acupuncture at Lung 5 (ST, n = 27), and no acupuncture (CT, n = 27). During time 0–30 minutes (baseline), occurrences of hypersalivation, vomiting and licking were recorded. At 30 minutes, subjects were administered hydromorphone (0.1 mg kg−1) in combination with acepromazine (0.03 mg kg−1) intramuscularly. During time 30–45 minutes (post-injection), occurrences of hypersalivation, vomiting and licking were recorded by an observer unaware of group assignment. Groups were compared using a Kruskal–Wallis test followed by a Dunn's post-test, or Fisher's exact tests when appropriate.There were no significant differences in age, weight or baseline observations among groups. Vomiting incidence post-injection was higher in the CT (20/27, 74.1%) and ST (22/27, 81.5%) groups than in the AT (10/27, 37.0%) group (p = 0.0129 and p = 0.002, respectively). The number of vomiting episodes [median (range)] after opioid administration was higher in the ST [1 (1–6)] than the AT [0 (0–2)] group (p = 0.0040). There were no differences in the median number of vomiting episodes between the ST and CT [1 (0–3)] or AT and CT groups. There were no differences in hypersalivation or licking among groups after hydromorphone–acepromazine administration.Pericardium 6 acupuncture reduced the incidence of hydromorphone-induced vomiting in healthy dogs. This cost-effective technique can improve patient well-being and comfort during the perioperative period.