Vomiting is a common clinical sign in the paediatric age group, including neonates. It is the forced expulsion of gastric content through the mouth and must be differentiated from gastro-oesophageal reflux. Vomiting in neonates is usually a non-specific clinical sign and may correspond to gastrointestinal abnormalities, but it can also signal systemic disorders such as infectious pathologies, intracranial injuries with intracranial hypertension, and endocrine and metabolic diseases. Physicians should be able to recognize life-threatening causes of vomiting in order to avoid serious complications. This review considers congenital gastrointestinal malformations, infections and other less common causes of vomiting in neonates.