Intestinal microbiota and Keto-diet roles: a powerful contributor to patient disease recovery Abstract Intestinal microbiota (IM) is a key contributor to host metabolism and physiology. Data generated on comparing diseased and healthy subjects have reported changes in the IM profile between both health states, suggesting certain bacterial composition could be involved in pathogenesis. Moreover, studies reported that modify of intestinal microbiota, is a growing interest on nutritional approaches as non-pharmacological approaches (NPAs), could contribute actively to disease recovery. Interestingly, ketogenic diets (KD) have emerged recently as new diet therapeutic strategy to combat a myriad of diseases (obesity, diabetes, cancer, neurodegenerative diseases, immunosystem deficit…). Keto-diet, refers to whatever dietetic which causes physiological ketosis. Therefore, high fat-low carbs diets, fasting periods or caloric restriction constitute different strategies to produce an increase of main ketones bodies, acetoacetate and β- hydroxybutyrate, in blood. However, it has been pointed out that IM modify by KD, from now on “keto microbiota”, may play a crucial role in patient response to KD treatment. In this review, we describe the potential benefits of KD and the influence of gut microbiota on host, the management of several diseases, exploring applicability and mechanisms of KD. In fact current progress and limitations will be argued too. Reinforcing keto microbiota might be a new useful therapeutic agent as a powerful contributor to restore health status of the patient from diseases recovery.