It is encouraging to see how data have informed such a critical concept in acute care medicine. Hyperkalemia is a life-threatening condition surrounded by significant clinical uncertainty and misconceptions. The lack of high-quality evidence regarding which agents are truly effective has long posed a challenge. This systematic review brings together the available evidence to clarify what works and what does not. We hope that standard care practices will continue to evolve and align more closely with evidence-based medicine to improve patient outcomes.