Ketone compounds have important physiological properties. They are found in several sugars (sugar) and in compounds for medicinal use, including natural and synthetic steroid hormones (steroid hormone). Molecules of the anti-inflammatory agent cortisone contain three ketone groups.

Only a small number of ketones are manufactured on a large scale in industry. They can be synthesized by a wide variety of methods, and because of their ease of preparation, relative stability, and high reactivity, they are nearly ideal chemical intermediates. Many complex organic compounds are synthesized using ketones as building blocks. They are most widely used as solvents, especially in industries manufacturing explosives (explosive), lacquers, paints (paint), and textiles (textile). Ketones are also used in tanning, as preservatives, and in hydraulic fluids.

The most important ketone is acetone (CH₃COCH₃), a liquid with a sweetish odour. Acetone is one of the few organic compounds that is infinitely soluble in water (i.e., soluble in all proportions); it also dissolves many organic compounds. For this reason—and because of its low boiling point (56 °C 【132.8 °F】), which makes it easy to remove by evaporation when no longer wanted—it is one of the most important industrial solvents, being used in such products as paints, varnishes (varnish), resins (resin), coatings, and nail-polish removers.

The International Union of Pure and Applied Chemistry (IUPAC) name of a ketone is derived by selecting as the parent the longest chain of carbon atoms that contains the carbonyl group. The parent chain is numbered from the end that gives the carbonyl carbon the smaller number. The suffix -e of the parent alkane (paraffin hydrocarbon) is changed to -one to show that the compound is a ketone. For example, CH₃CH₂COCH₂CH(CH₃)₂ is named 5-methyl-3-hexanone. The longest chain contains six carbon atoms and numbering of the carbon must begin at the end that gives the smaller number to the carbonyl carbon. The carbonyl group is on carbon 3, and the methyl group is on carbon 5. In cyclic ketones, numbering of the atoms of the ring begins with the carbonyl carbon as number 1. Common names for ketones are derived by naming each carbon group bonded to carbon as a separate word followed by the word “ketone.”

The simplest ketone, CH₃COCH₃, whose IUPAC name is 2-propanone, is almost always called by its common name, acetone, which is derived from the fact that it was first prepared by heating the calcium salt of acetic acid.

Ketones are highly reactive, although less so than aldehydes (aldehyde), to which they are closely related. Much of their chemical activity results from the nature of the carbonyl group. Ketones readily undergo a wide variety of chemical reactions. A major reason is that the carbonyl group is highly polar; i.e., it has an uneven distribution of electrons (electron). This gives the carbon atom a partial positive charge, making it susceptible to attack by nucleophiles (nucleophile), which are species attracted to positively charged centres. Typical reactions include oxidation-reduction (oxidation–reduction reaction) and nucleophilic addition. The polarity of the carbonyl group affects the physical properties of ketones as well.

Secondary alcohols (alcohol) are easily oxidized to ketones (R₂CHOH → R₂CO). The reaction can be halted at the ketone stage because ketones are generally resistant to further oxidation. Oxidation of a secondary alcohol to a ketone can be accomplished by many oxidizing agents, most often chromic acid (H₂CrO₄), pyridinium chlorochromate (PCC), potassium permanganate (KMnO₄), or manganese dioxide (MnO₂). With a few exceptions (such as oxidative cleavage of cyclohexanone, C₆H₁₀O, to adipic acid, HO₂C【CH₂】₄CO₂H, a compound used to make nylon-6,6), the oxidation of ketones is not synthetically useful.

The treatment of an aromatic hydrocarbon with an acyl halide or anhydride in the presence of a catalyst composed of a Lewis acid (i.e., a compound capable of accepting an electron pair), most often aluminum chloride (AlCl₃), gives an aryl alkyl or diaryl ketone (ArH → ArCOR or ArCOAr′), where Ar represents an aromatic ring. This reaction is known as Friedel-Crafts acylation.

Nitriles (nitrile) (RCN) react with Grignard reagents (Grignard reagent) to produce ketones, following hydrolysis (RCN + R′MgX → RCOR′).

Ketones possessing α-hydrogens can often be made to undergo aldol reactions (also called aldol condensation) by the use of certain techniques. The reaction is often used to close rings, in which case one carbon provides the carbonyl group and another provides the carbon with an α-hydrogen. An example is the synthesis of 2-cyclohexenone. In this example, the aldol product undergoes loss of H₂O to give an α, β-unsaturated ketone.