The present article was aimed to study demographic and clinical pattern, periodicity and precipitating events for hypokalemic paralysis and to assess the response to treatment both during acute attacks and as prophylaxis in comparison with available literature. Forty patients with hypokalemic paralysis were admitted in Narayana Medical College and Hospital during the last two years, in all the medical units and neurology wards. Patients were assessed clinically, with symptomatology and precipitating factors were evaluated. There were total 40 patients in the present study. Younger more including male gender. Mean age was 30.95 years. Common precipitating factor were diarrhea, fever, strenuous activity, following dextrose administration, in patients with diabetic ketoacidosis, however in majority of the cases we could not identify the precipitating factors. Most common electrocardiographic change on ECG was U' wave (36 cases) followed by flat 'T' wave (14 patients) and ECG was normal in 4 patients. Hypokalemic paralysis was predominantly seen in younger males. Vomiting, diarrhea were important precipitating factors. The response to oral potassium chloride supplementation was good as only few patients requiring intravenous potassium chloride. The approach to hypokalemic paralysis patient includes a vigorous search for the underlying etiology and potassium replacement therapy.