Health problems occurring during the transition period in dairy cattle are of utmost importance as they can decrease the animal’s reproductive performance and favor the development of various metabolic diseases with resultant significant reproductive disorders. Among the commonly reported metabolic diseases occurring during that time, hyperketonemia is the most prevalent and could provoke a significant economic impact. The failing of a dairy cow to transit optimally between pregnancy and lactation is economically very relevant and should be considered. Until now, the role of insulin resistance (IR) in the etiology of subclinical ketosis (SCK) in dairy cattle is not clearly understood. This review aims to shed some light on the role of IR and oxidative stress in dairy cows with SCK during the transition period. The data presented in this review demonstrates that dairy cows could be vulnerable to the development of negative energy balance during transition. Moreover, the transitional cows could succumb to both IR and oxidative stress; however, the exact role of IR in cows with SCK needs further investigations. It is imperative to elaborate a suitable nutritional strategy to facilitate an easy transit of cows through this critical period and to minimize health problems and improve productivity during lactation.