Objective: Postoperative nausea and vomiting (PONV) is a common complication after middle ear surgery. We have aimed to compare the administration of a subhypnotic dose of propofol with dexamethasone 4 mg or 8 mg and placebo in prevention of postoperative nausea and vomiting (PONV) after middle ear surgery. Method: This clinical research was performed at Yüksek Ihtisas Hospital Kirikkale. The study included 105 adult patients scheduled for a middle ear operation. The patients were randomly assigned into three groups. The patients in Group I received propofol in a dose of 0.5 mg.kg-1 plus 4 mg of dexamethasone while Group II was administered with propofol in a dose of 0.5 mg.kg-1 plus 8 mg of dexamethasone, and Group III was given 0.9 % saline solution. Within the framework of the study we evaluated the number of patients suffering from nausea and vomiting at 0-4,4-12, and 12-24 hours postoperatively, and the necessity to use additional antiemetics. Results: The comparison of data showed that at up to four hours, the incidence of vomiting was 28.6 % in Group I, 22.9 % in Group II, and 65.7 % in Group III. The incidence rates in Group I and Group II were significantly lower than that in Group III (p<0.05), while the rate of antiemetic drug usage was higher in Group III than in Group I and Group II (p<0.05). The Nausea Vomiting Scale scores were also significantly higher in Group III than in Group I and Group II (p<0.05). There were no significant differences between the values at 4-12 and 12-24 hours. Conclusion: The administration of a subhypnotic dose of propofol plus 4 mg of dexamethasone at the end of surgery was found to be at least as effective as propofol plus 8 mg of dexamethasone in preventing the PONV in the early postoperative period in adult patients undergoing middle ear surgery.