【Abstract】 Objective To determine the diagnostic value of serum beta-hydroxybutyrate (βOHB) in diabetic ketosis or diabetic ketoacidosis. Methods We conducted a retrospective review of clinical data, in West China Hospital from May 2011 to May 2013, of 1 209 patients with non-ketosis diabetics (DM group), 262 patients with diabetic ketosis or diabetic ketoacidosis (DK/DKA group), and 480 healthy people undergoing routine medical examinations (normal control group). Logistic regression analyses and ROC curves were performed in determining the diagnostic value of βOHB for DK/DKA. Results The level of serum βOHB was much higher in the DK/DKA patients than that of the participants in the DM group and normal control group (PP