Alcoholic ketoacidosis (AKA) is a specific group of symptoms and metabolic state related to alcohol use. Symptoms often include abdominal pain, vomiting, agitation, a fast respiratory rate, and a specific "fruity" smell. Consciousness is generally normal. Complications may include sudden death.

AKA most commonly occurs in long term alcoholics and less commonly in those who binge drink. Onset is generally after a decreased ability to eat for a few days. Diagnosis is generally based on symptoms. Blood sugar levels are often normal or only mildly increased. Other conditions that may present similarly include other causes of high anion gap metabolic acidosis including diabetic ketoacidosis.

Treatment is generally with intravenous normal saline and intravenous sugar solution. Thiamine and measures to prevent alcohol withdrawal are also recommended. Treatment of low blood potassium may also be required. Those who are affected are most frequently between the ages of 20 and 60. The condition was initially recognized in 1940 and named in 1971.