China's economy has developed rapidly in the last two decades, leading to an increase in energy consumption and consequently emissions from energy generation. Coal is a primary energy source in China because of its abundance and will continue to be used in the future. The dominance of coal in energy production is expected to result in increasing levels of exposure to environmental pollution in China. Toxic trace elements emitted during coal combustion are the main sources of indoor air pollution. They are released into the atmosphere mainly in the forms of fine ash and vapors and have the potential to adversely affect human health. Those trace elements, which volatilize during combustion, are hazardous air pollutants (HAPs) and are particularly rich in Chinese coals. Among the HAPs, arsenic (As), fluorine (F), and selenium (Se) have already been identified as pollutants that can induce severe health problems. In this review, the geochemical characteristics of As, F, and Se, including their concentration, distribution, and mode of occurrences in Chinese coal, are documented and discussed. Our investigations have confirmed the current As- and F-induced epidemics in Guizhou (Southwest China) and Se epidemic in Hubei (Northeast China). In this study, diagnostic symptoms of arseniasis, fluorosis, and selenosis are also illustrated.