Objective: We report a case of a patient with major depressive disorder caused by diabetic gastroparesis-related severe nausea and vomiting. Case Report: The patient responded poorly to prokinetic agents, but her symptoms, such as depression, nausea/vomiting, were improved after the prokinetic agents were combined with mirtazapine. She was discharged in a stable condition and kept receiving mirtazapine. She did not show any recurrent depression, and diabetic gastroparesis-related severe nausea and vomiting during follow-up. Conclusion: This is the first case report to show that mirtazapine may be effective for treating and preventing recurrent depression caused by diabetic gastroparesis-related severe nausea and vomiting.