Abstract: As one of the research directions of novel dietary adjuvant treatment for heart diseases, ketogenic diet has the advantages of improving risk factors, inhibiting ventricular remodeling, and protecting the heart. This paper reviews and summarizes the research achievements of the effect of ketogenic diet on heart diseases and cardiovascular risk factors, elaborates the heart-related mechanism from multiple perspectives, analyzes its positive impacts on reducing cardiovascular disease risk factors and treating heart-related diseases, and summarizes the adverse reactions and contraindications of ketogenic diet, so as to provide new ideas for the prevention and treatment of heart diseases.