Three Chinese girls with hypokalemic periodic paralysis secondary to different types of renal tubular acidosis are presented. One girl has primary distal renal tubular acidosis complicated with nephrocalcinosis. Another has primary Sjogren syndrome with distal renal tubular acidosis, which occurs rarely with hypokalemic periodic paralysis in children, The third has an isolated proximal renal tubular acidosis complicated with multiple organ abnormalities, unilateral carotid artery stenosis, respiratory failure, and consciousness disturbance, The diagnostic evaluation and emergent and prophylactic treatment for these three types of renal tubular acidosis are discussed.