The purpose was to determine the difference of blood clinicopathological changes between type Ⅰ and type Ⅱ ketosis in dairy cow.Forty-six cows, from dairy cattle farm in Heilongjiang of China, were included.An ELISA test was used to evaluate the blood indicators.The plasma concentrations of beta-hydroxybutyric acid (BHBA) and insulin sensitivity decreased, and the plasma concentration of glucose (Glc), non-esterified fatty acid (NEFA) and bilirubin content increased in type Ⅱ ketosis group compared with the type Ⅰ ketosis group.These results show that there is a difference in etiology between type Ⅱ ketosis and type Ⅰ ketosis.Type Ⅱ ketosis was not only associated with energy metabolism and insulin resistance, but also with oxidative stress and liver function.It laid the foundation for further investigate the mechanism and prevention of type Ⅱ ketosis in the future.