Euglycemic ketoacidosis is a rare but potentially fatal complication of treatment with SGLT2 inhibitors (gliflozins). However, similar euglycemic ketoacidosis may rarely occur with other antidiabetic drugs or conditions such as pregnancy or alcohol abuse. We describe 3 cases of our patients with euglycemic ketoacidosis associated with gliflozins and 1 case associated with the DPP4 inhibitor sitagliptin and discuss in detail the acid-base disturbances present and the distinction of euglycemic ketoacidosis from classical ketoacidosis in type 1 diabetes.