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Lysine β-hydroxybutyrylation (Kbhb) is a novel post-translational modification mediated by the ketone body β-hydroxybutyrate (BHB). Kbhb levels are dynamically regulated under ketogenic metabolic conditions, including fasting, ketogenic diets, and prolonged physical exercise. Emerging evidence has highlighted Kbhb as an important metabolic-epigenetic interface that connects cellular energy status with chromatin regulation and protein function. Kbhb has demonstrated regulatory roles across diverse biological contexts, including oncology, immunomodulation, metabolic homeostasis, circadian remodeling, and developmental processes.