We present an investigation of the decarboxylation reaction of ketoprofen (KP) induced by triplet excited-state intramolecular proton transfer in water-rich and acidic solutions. Nanosecond time-resolved resonance Raman spectroscopy results show that the decarboxylation reaction is facile in aqueous solutions with high water ratios (water/acetonitrile ≥50%) or acidic solutions with moderate and strong acid concentration. These experimental results are consistent with results from density functional theory calculations in which 1) the activation energy barriers for the triplet-state intramolecular proton transfer and associated decarboxylation process become lower when more water molecules (from one up to four molecules) are involved in the reaction system and 2) perchloric acid, sulfuric acid, and hydrochloric acid can shuttle a proton from the carboxyl to carbonyl group through an initial intramolecular proton transfer of the triplet excited state, which facilitates the cleavage of the C-C bond, thus leading to the decarboxylation reaction of triplet state KP. During the decarboxylation process, the water molecules and acid molecules may act as bridges to mediate intramolecular proton transfer for the triplet state KP when KP is irradiated by ultraviolet light in water-rich or acidic aqueous solutions and subsequently it generates a triplet-protonated carbanion biradical species. The faster generation of triplet-protonated carbanion biradical in acidic solutions than in water-rich solutions with a high water ratio is also supported by the lower activation energy barrier calculated for the acid-mediated reactions versus those of water-molecule-assisted reactions.