Low-level caching with Rails.cache uses the fetch method to check if a cache key exists. When you call Rails.cache.fetch with a key, it first looks in the cache. If the key is found, it returns the cached value without running the block. If the key is not found, it runs the block, stores the block's result in the cache under that key, and returns the new value. This means the block runs only once per cache miss. Subsequent calls with the same key return the cached value quickly. If the cache is cleared or the key expires, the block runs again to refresh the cache. This pattern helps speed up applications by avoiding repeated expensive operations.