Typically these are used like this: your mail server gets an SMTP connection from some address (let's use the familiar IPv4 example): 10.20.30.40.
You reverse these octets and do an "A" record dns query to some 40.30.10.10.dnsbl.example.com to look up that IP in example.com's list. If a match is returned, the address is listed. If you do a "TXT" record query, you can find out why it's listed.
Block lists are typically blacklists, but they can be whitelists as well.
DNSBL's are hammered with queries from vast numbers of mail servers; DNS keeps things efficient.