Nausea and vomiting are common symptoms experienced by pregnant women during the first trimester, primarily associated with hormonal and physiological changes. Ginger, lemon, honey, and vitamin B6 have been widely used as complementary approaches to alleviate pregnancy-related nausea and vomiting. This study aimed to evaluate and compare the effectiveness of three interventions: ginger-lemon-honey, ginger-lemon-honey combined with vitamin B6, and vitamin B6 alone in reducing nausea and vomiting among pregnant women with emesis gravidarum. A quasi-experimental study with a three-group pretest-posttest design was conducted among 45 first-trimester pregnant women experiencing nausea and vomiting. Participants were selected using purposive sampling and allocated into three intervention groups: ginger-lemon-honey, ginger-lemon-honey plus vitamin B6, and vitamin B6 alone. Nausea and vomiting severity was assessed before and after the intervention using the Pregnancy-Unique Quantification of Emesis (PUQE-24) scale. Data were analyzed using univariate analysis, one-way ANOVA, and ANCOVA to evaluate differences between groups after adjustment for baseline scores. All three intervention groups demonstrated a significant reduction in nausea and vomiting following the intervention (p < 0.001). The ginger-lemon-honey plus vitamin B6 group showed the lowest adjusted mean PUQE-24 score of 6.002 (95% CI [5.4–6.5]), followed by the ginger-lemon-honey group with an adjusted mean of 7.590 (95% CI [7.0–8.1]), and the vitamin B6 group with an adjusted mean of 9.342 (95% CI [8.8–9.8]). These findings indicate that the combined ginger-lemon-honey and vitamin B6 intervention resulted in the lowest adjusted PUQE-24 score compared with either intervention alone. The combination of ginger, lemon, honey, and vitamin B6 was more effective in reducing nausea and vomiting among first-trimester pregnant women with emesis gravidarum than ginger-lemon-honey or vitamin B6 alone. This combined intervention may provide a comprehensive complementary approach through mechanisms involving gastrointestinal, neurological, psychological, and metabolic pathways.