In the course of studying the control of blood glucose in juvenile onset diabetics, we developed convenient methods for determining beta-hydroxybutyrate and acetoacetate. Here we describe fixed-time, enzymic, reaction-rate procedures for directly measuring these organic acids with a centrifugal analyzer (Rotochem IIA/36) or a computer-backed spectrophotometer (Gilford 102 system). In either case, the method requires only 20 micro L of plasma; is rapid, accurate, and precise; and analytical recovery is quantitative. Data are presented comparing results obtained with both instruments. Metabolic acidosis can be rapidly assessed and monitored with these methods, as illustrated by an example.