Alright, here's my attempt at making kuo-toa a playable race option for pcs. I tried to keep it balanced and open to as many class options as possible to encourage variety. My choices in the class features and feats were based on the monster manuals for both 4e and 3.5 that contained kuo-toa. I also introduced a "new" god from the older editions that went along with the kuo-toa. This is definitely PEACH, since even though I tried to balance it, that doesn't mean I really know what I'm doing.
Enjoy.
A primer: Kuo-Toa are a fish-like species of Usually-Chaotic-Evil dudes that dwell in the aquatic regions of the underdark. They have a very Lovecraftian feel to them, and worship such "dark gods" and aberrant creatures as you would expect from that. Their cities are tainted by madness, and sometimes can become ruins in a matter of days if the madness overwhelms them entirely. Kuo-Toa leaders are made up of a priest-caste, called Whips (clerics). There are also Moniters, kuo-toa who have learned to fight with their bodies and harden their mind to the ever present madness within their aquatic societies (monks). Kuo-toa are known to form short lived alliences with drow and other underdark races.
KUO-TOA

RACIAL TRAITS
Average Height: 4'7"-5'6"
Average Weight: 140-200 lb.
Ability Scores: +2 DEX; +2 CON or +2 WIS
Size: Medium
Speed: 6, swim 6
Vision: Low-Light Vision
Languages: Common, Deep Speech
Skill Bonuses: +2 Dungeoneering, +2 Perception
Aquatic: You count as an aquatic creature for all rules and effects that apply to them, and do not take the penalty to attack rolls from being under water.
Slimy Skin: You can make a check to escape a grab as an immediate reaction.
Slick Maneuver: You do not provoke opportunity attacks from a creature by moving into another square adjacent to it.
Racial Power: You have the racial power encounter power.
Racial Power
HEROIC FEATS
Kuo-Toa Mancatcher Training
Prerequisits: Kuo-Toa, 13 strength or dexterity
You gain proficiency and a +2/+3/+4 per tier feat bonus to damage rolls with nets. Whenever you hit a creature with an attack using a net, that creature is slowed until the end of your next turn.
Aberrant Familiarity
Prerequisits: Kuo-Toa
You gain a +5 bonus to damage rolls against aberrant creatures, but suffer a -2 penalty to saving throws against effects caused by an aberrant creature's attack.
Kuo-Toa Whip Training
Prerequisits: Kuo-Toa, 15 dexterity, any divine class
Gain proficiency with the zadatl and treat it as a +3 proficiency, 1d12 weapon. You can use it as an implement for your divine powers. You gain a +2/+3/+4 bonus to damage rolls with attacks made with a zadatl, and creatures take a -2 penalty to checks to escape grabs caused by your zadatl.
Kuo-Toa Moniter Training
Prerequisits: Kuo-Toa, monk class
Gain a +1 bonus to will defense and a bonus to saving throws against effects that dominate, stun, daze, or deal ongoing psychic damage equal to your wisdom modifier.
Lurker In The Deep
Prerequisits: Kuo-Toa
While under water, you gain combat advantage against creatures that are not under water and against non-aquatic creatures that are under water. In addition, you can make a stealth check while under water to become hidden.
Deft Swimmer
Prerequisits: Aquatic
Your swim speed increases by 2.
Aberrant Madness
Prerequisits: Kuo-Toa, warlock, star pact
You can choose one target of your warlock daily attack powers to make a melee basic attack against any creature of your choice within range as a free action. Also, you take a -2 penalty to saving throws against effects that dominate.
Oak-Jaw Coven Training
Prerequisits: Kuo-Toa, any primal class
You gain a benefit with any of the following powers you posses.
Grasping Claws (druid): You can grab the target of this attack until the end of your next turn if you hit with it.
Haunting Spirits (shaman): You can grab the target of this attack until the end of your next turn if you hit with it.
Thorn Strike (warden): You can grab the target of this attack until the end of your next turn if you hit with it.
Howling Strike (barbarian): If you are grabbed, you can charge with this attack to escape the grab. You do not provoke opportunity attacks from the creature grabbing you from movement made as part of this charge.
Blibdoolpoolp's Eye [Divinity]
Prerequisits: channel divinity class feature, you must worship Blibdoolpoolp
You gain the Channel Divinity power Blibdoolpoolp's eye.
Blibdoolpoolp's Eye
Standard Action, Close Blast 3
Divine, Implement, Psychic, Channel Divinity
Target: One creature in the blast
Attack: Wis vs. Will
Hit: You slide the target 2 squares and it makes a melee basic attack against a creature of your choice. If its attack misses, it takes psychic damage equal to your wisdom modifier.
Channel Divinity: You can only use one channel divinity power per encounter
PARAGON FEATS
Sticky Shield
Prerequisits: Kuo-Toa, 11th level, proficiency in light or heavy shields
When using a light or heavy shield, creatures must make a saving throw or be grabbed by you until the end of your next turn if they miss you with a melee attack.
Keen Eye
Prerequisits: Kuo-Toa, 11th level
You gain darkvision, and can see invisible creatures until the end of your next turn if they move while within 2 squares of you. In addition, you have a +2 feat bonus to perception.
Kuo-Toa Harpooner
Prerequisits: Kuo-Toa, 11th level, 15 strength
Your ranged basic attacks with weapons in the spear or crossbow group pull the target 2 squares.
Kuo-Toa Lurker
Prerequisits: Kuo-Toa, 11th level, rogue
You can treat weapons in the spear group as light blades for the purpose of meeting prequisits for your rogue powers, rogue paragon path powers, and rogue class features.
Curse of the Deep One
Prerequisits: Kuo-Toa, 11th level, warlock class, star pact
Creatures under your warlock's curse take a -2 penalty to saving throws.
Racial Power Enhancer
Prerequisits: Kuo-Toa, 11th level
Your racial power is now enhanced.
EPIC FEATS
Lightning Affinity
Prerequisits: Kuo-Toa, 21st level, 17 dexterity
You gain a +4 feat bonus to damage rolls with lightning powers. In addition, whenever you hit with a lightning power, each creature adjacent to the target of the power takes lightning damage equal to your dexterity modifier.
Racial Power Enhancer II
Prerequisits: Kuo-Toa, 21st level
Your racial power is now enhanced.
Unleashed Madness
Prerequisits: Kuo-Toa, 21st level
When you make a weapon attack against an enemy, you can take a -1 penalty to will defense until the end of your next turn to deal your dexterity modifier damage to each creature within melee range of you.
PARAGON PATH
KUO-TOA LEVIATHAN
I can feel the monster inside me, the tempest of power waiting to be unleashed... Do you dare to be the one to feel its wrath?

Kuo-Toa Leviathan Path Features
Wave Maker (Level 11): When you spend an action point to take an extra action, you can push all creatures in a close burst 3 centered around you 2 squares and knock them prone.
Titanic Form (Level 11): Your melee reach increases by 1.
Titanic Impact (Level 16): Choose strength, dexterity, or constitution. All your attacks deal extra damage equal to the chosen ability modifier.
Kuo-Toa Leviathan Powers
Leviathan's Tide Level 11 Encounter
Standard Action, Close burst 3
Zone
Target: Each enemy in the burst
Attack: STR, DEX, or CON + 6 vs. Fort
Hit: 2d12 plus strength, dexterity, or constitution modifier damage, and the target is slid two squares and slowed.
Effect: The burst creates a zone of water 3 squares deep. The zone lasts until the end of the encounter or until you end it as a free action on your turn.
Special: The attack roll increases to STR, DEX, or CON + 9 at level 21. Chose which ability score to use for this attack when you select Kuo-Toa Leviathan as your paragon path.
Thrashing Rampage Level 12 Utility
Minor Action, Personal
Stance
Effect: You enter the thrashing rampage stance. The stance lasts until the end of the encounter, and you can end it as a free action. While in the stance you have threatening reach, and your melee attacks slide targets 1 square.
Blibdoolpoolp's Blessing Level 20 Daily
Standard Action, Close Burst 1
Polymorph
Target: Each creature in the burst
Attack: STR, DEX, or CON + 6 vs. Fort
Hit: 3d12 plus strength, dexterity, or constitution modifier damage, and the target is stunned until the beginning of your next turn.
Effect: Each creature adjacent to you is pushed one square. You then assume the form of Blibdoolpoolp's chosen. In this form your size is large, you gain a +2 power bonus to all defenses, and your attacks can pull or push the target 1 square. You also gain temporary hit points equal to twice your healing surge value.
Special: The attack roll increases to STR, DEX, or CON +9 at level 21. Chose which ability score to use for this attack at level 20 when you gain it.
DEITY
BLIBDOOLPOOLP

Blibdoolpoolp is the patron goddess of the kuo-toa, who refer to her as the Sea Mother. Mad cultists among the other races are known to pledge alliegence to her goals of spreading madness and seeking vengeance upon the other gods as well. However, the worship of Blibdoolpoolp is in decline, as the kuo-toa who once singularily worshipped her are now prone to worship aberrant terrors of the deep instead, or in some secluded tribes, primal spirirts. Blibdoolpoolp's sacred animal is the lobster, and her idols are often lobsters made from jewelry, most often aquamarines and gold. The kuo-toa represent Blibdoolpoolp as a bloated caricature of the female human form, with the claws and head of a lobster. During the Dawn War, Blibdoolpoolp's vanity caused her to try and defect to the primordials. She assumed that she would quickly become the leader of their entire army. Instead, the primordials rejected her and destroyed her domain within the Astral Sea. Knowing of her treachery, the other gods banished Blibdoolpoolp to an aquatic prison within the elemental chaos. Eventually Blibdoolpoolp managed to spread her influence into the natural world, in the deepest waters of the underdark. There, the ancient kuo-toa became her first followers.
Blibdoolpoolp's teachings are as follows:
* The Sea Mother is a demanding patron. Worship no other gods but her, and make sacrifices in her name. Held highest of all is the sacrifice of lobsters, her sacred animal.
* Hold all surface dwellers in comtempt, and seek vengeance against those who cast the Sea Mother into the watery depths of the underdark.
* Be opportunistic. Forge alliences that will benefit you and only break them once they become disadvantageous.
* Plant the seed of insanity wherever you can, and sow confusion among the lawful.
Alignment: Chaotic Evil
Domains: Sea, Destruction, Torment, Madness