Background: One of the most serious acute metabolic complications of type 1 diabetes (T1D) is diabetic ketoacidosis (DKA), which is characterised by acidosis, ketosis, and frequently hyperglycemia. Objectives: To summarize the recent epidemiological data and risk factors for developing DKA in adult T1D patients. Methods: PubMed, SCOPUS, Web of Science, and Science Direct were systematically searched for relevant literature. Rayyan QRCI was employed throughout this comprehensive process. Results & interpretation: We included eleven studies with a total of 104388 participants, and 52733 (50.5%) were males. The incidence of DKA in patients with T1D ranged from 2% to 64.8%. Risk factors for developing DKA included non-adherence, alcohol, higher HbA1c levels, longer-term diabetes, teenage age group, female gender, associated comorbid conditions, and intake of fat and carbohydrates. It's interesting to note that despair, drug misuse, and social deprivation are prevalent among DKA patients who are admitted. Consuming fibre and using freeStyle Libre protected T1D patients from developing DKA. Future research is obviously needed to provide a more comprehensive description of the epidemiology of DKA among adult T1D patients.