Procedures for the analysis of free α-keto acids in human fluids (i.e. plasma, cerebrospinal fluid, urine, etc.) as well as for studying the dynamic free α-keto acid pools in differentiated tissues and organ cells have been the subject of growing clinical interest in the study of metabolic regulatory and pathophysiological phenomena. Due to the high instability and polarity of the α-keto acids being examined, the development of a quantitative and reproducible analysis of metabolically relevant intracellular α-keto acids still presents a substantial methodological challenge. The aim of small sample size, rapid, non-damaging and “metabolism-neutral” cell isolation, careful sample preparation and stability, as well as reproducible analytics technology is not often achieved. Only few of the methods described can satisfy the rigorous demands for an ultra-sensitive, comprehensive and rapid intracellular α-keto acid analysis.