Introduction: Ketoacidosis is one of the acute metabolic complications of diabetes. It is more common and has a higher death rate in India &south Asia. To our knowledge, there are very few studies done on diabetic ketoacidosis in Madhya Pradesh. The aim of our study was to determine the hospital prevalence of diabetic ketoacidosis, to describe their epidemio-clinical features as well as to look for determinants of hospital mortality in patients attending Bundelkhand Medical college tertiary hospitalMethods: This is a descriptive retrospective study of diabetics admitted to this unit for ketoacidosis, over a period of 15 months (from January 1, 2021, to March 30, 2022). Results: Sixty-four patients were selected for the study. The hospital prevalence of ketoacidosis was 5.61%. The mean age of the patients was 46.3 years with a sex ratio of 0.94. Type 2 diabetes predominated in terms of frequency (62.5%). In 37.5% of cases, ketoacidosis was the inaugural diabetes. For patients known to be diabetic before admission, infection was the most common etiologic factor (48.44%), followed by discontinuation of treatment (31.25%).