Abstract The metabolic changes that occur during the early post‐partum period in dairy cows can indeed lead to an imbalance in energy utilization, resulting in the production of excessive ketone bodies. This can have detrimental effects on the cow's health and milk production, leading to economic losses for dairy producers. The release of non‐esterified fatty acids into the blood due to increased lipolysis is a key factor in the development of ketosis. Abdominal adiposity is a key factor on these outcomes in modern dairy cows. The redirection of energy and glucose towards lactose synthesis and milk yield leaves a deficit of gluconeogenic precursors, leading to the conversion of acetyl‐CoA into ketone bodies instead of entering the Krebs cycle. These ketone bodies, including acetone, acetoacetate and β‐hydroxybutyrate, accumulate in the blood and can be detected in various bodily fluids, such as urine, blood and milk, allowing for diagnostic testing. Prevention is indeed crucial in managing ketosis in dairy cattle. Supplementation of propylene glycol in the diet or the use of monensin, either in the diet or in the form of a slow‐release bolus, can help prevent the occurrence of ketosis. However, avoiding high body condition (subcutaneous fat) and excessive abdominal adiposity during the dry period and parturition plus an adequate cow comfort are fundamental tasks to avoid ketosis and related disorders. These interventions aim to provide additional energy sources or enhance the cow's ability to utilize energy efficiently, thus reducing the reliance on excessive lipolysis and ketone body production.