This systematic review aims to assess the safety and effectiveness of intravenous beta-hydroxybutyrate (BHB) as a treatment for acute conditions such as traumatic brain injury. Therapeutic ketosis is traditionally induced with dietary modification, but it is not practical for acute conditions due to the time delay involved. Intravenous administration of ketones would rapidly induce ketosis, but currently no such product exists. The review includes studies on small animals and humans, and searched the Web of Science, PubMed and EMBASE databases.