Summary: Acute gouty arthritis is the most common form of arthritis that requires urgent pharmacological treatment. The recommended drugs of first choice in a gout attack are colchicine, non-steroidal anti-inflammatory drugs and glucocorticosteroids. The article presents the rules of treatment based on the current recommendations and results of clinical trials. The latest therapeutic options with interleukin 1 (IL-1) inhibitors are also included. In each case, it is extremely important to select the drug individually for a specifi c patient. The presence of comorbidities, contraindications, the possibility of drug interactions, duration of the attack and the severity of symptoms should be taken into account.