Acidosis is a common clinical finding with serious consequences. Most of these disorders are due to high anion-gap metabolic acidosis or GIT causes. It's important to differentiate various types of metabolic acidosis due to differences in management and workup. Renal tubular disorders are not very common, but a significant number of these cases are lifelong and also need follow-up for ongoing monitoring. These disorders also have a significant long-term impact on patients' electrolytes, kidneys, and bones. Many medical graduates and trainees find it hard to understand the underlying pathophysiology and tests used for diagnostic purposes. Additional difficulties in the management are faced due to the complex nature of these diagnostic approaches. There are often delays in the diagnosis due to the rarity, complexity, and overlapping nature of these disorders. This review focuses on the various pathophysiological and clinical facts based on international guidelines. The purpose is to provide a clear understanding and approach to managing such cases.