One of the most important developments in Earth Science is the invention of quantitative reconstruction of paleoelevation. This paper summarizes two approaches adopted in the stable isotope based paleoaltimetry, i.e., empirical calibrations of the isotopic lapse rates of precipitation and theoretical calculations of the isotopic lapse rates of precipitation, and address the origins and ranges of the deviation associated with these methods. Based on the study of the stalagmites in Asian monsoon regions, the paper further evaluates the errors induced by the climate change in the reconstructions of both the precipitation isotope composition and the stable isotope lapse rate, and points out that the deviation associated with the climate change may equal to the sum of other error sources; the study of the stalagmite from caves located at different elevations may help to establish the isotope lapse rate under different climatic and environmental conditions; understanding the climatic and environmental background when the strata formed, selecting the appropriate isotope lapse rate and isotope composition of precipitation at low elevation site, and using multiple approaches for cross check will remarkably minimize the deviation of the reconstructed paleoelevation.