To investigate the correlation among semi-quantitative scoring of blood flow by superb microvascular imaging (SMI), hypersensitive C-reactive protein (hs-CRP), erythrocyte sedimentation rate (ESR), and serum uric acid (SUA) levels in different gout duration. 103 patients (total 157 affected joints) with clinically confirmed acute gout attack from January 2021 to May 2022 were performed with laboratory tests (hs-CRP, ESR, SUA), routine joint ultrasound scanning, along with semi-quantitative scoring of SMI, and correlations between which were analyzed. Statistically significant differences were found in semi-quantitative scoring of SMI in the affected joints between different disease duration. The differences between SMI scoring in gouty tophi, synovial hyperplasia, and the levels of different hs-CRP and ESR subgroups of the affected joints were statistically significant (p < 0.05). R values between SMI scoring in synovial hyperplasia as well as gouty tophi and hs-CRP levels were 0.711 and 0.579, respectively, and those of ESR were 0.430 and 0.418, respectively, while those of SUA levels were -0.227 and 0.120, respectively. With a prolonged progression of gout, hs-CRP and ESR levels amplify, along with a concurrent intensification in the SMI scorings of blood flow signals in the affected joints (grades 2 and 3). In the acute gout attack, SMI blood flow scoring showed a moderate correlation to hs-CRP, a low correlation to ESR, and no correlation to SUA, among which the best correlation was found between SMI scoring and hs-CRP levels in the synovial hyperplasia.