Exotic x-ray emission from dense matter is identified as the complex high intensity satellite emission from autoionizing states of highly charged ions. Among a vast amount of possible transitions, double K-hole hollow ion (HI) x-ray emission K0LX → K1LX−1 + hνhollow is of exceptional interest due to its advanced diagnostic potential for matter under extreme conditions where opacity and radiation fields play important roles. Transient ab initio simulations identify intense short pulse radiation fields (e.g., those emitted by x-ray free electron lasers) as possible driving mechanisms of HI x-ray emission via two distinct channels: first, successive photoionization of K-shell electrons, second, photoionization followed by resonant photoexciation among various ionic charge states that are simultaneously present in high density matter. We demonstrated that charge exchange of intermixing inhomogenous plasmas as well as collisions driven by suprathermal electrons are possible mechanisms to populate HIs to observable levels in dense plasmas, particularly in high current Z-pinch plasmas and high intensity field-ionized laser produced plasmas. Although the HI x-ray transitions were repeatedly identified in many other cases of dense optical laser produced plasmas on the basis of atomic structure calculations, their origin is far from being understood and remains one of the last holy grails of high intensity laser–matter interaction.