The synthesis of chiral ketones has been a long focus of chemistry research. Enantioselective radical hydroacylation, as a useful strategy to access various chiral ketones, was restricted to the reaction with β-substituted alkenes, in which a β-stereocenter was generated via a stereocontrolled radical addition to prochiral alkene. Herein, we realized a highly enantioselective radical hydroacylation of α-substituted α,β-unsaturated carbonyl compounds through direct hydrogen atom transfer in the presence of the photocatalyst anthraquinone and chiral N,N′-dioxide/metal complexes. This mild, robust method provided a facile access to a wide array of chiral ketones with α-tertiary stereocenters by using the readily available aldehyde as a hydroacylation reagent. Based on the spectroscopy experiments and control experiments together with DFT calculations, a hydrogen atom transfer/radical addition/enantioselective reverse hydrogen atom transfer sequence was proposed.