Gout is an inflammatory arthritis that is commonly associated with chronic diseases such as chronic kidney disease (CKD), hypertension, coronary vascular disease, and the metabolic syndrome. Therefore, the management of gout (treatment of the acute flare, lowering serum urate [sUA]) needs to take these co-morbid conditions in consideration. Recent advances in gout therapy showed the effectiveness of new and existing therapies in gout management and we will summarize those we consider to have the largest impact on our clinical practice in this article.