Summary: Although gout is the most common inflammatory arthritis, it is still frequently misdiagnosed and mismanaged. In this review the classification criteria and recent recommendations for diagnosis and methods of gout treatment are presented and discussed. Patient education and monitoring are critical to optimal gout outcomes. Most current clinical guidelines advocate a treat to target serum urate approach. Xantine oxidase inhibitors allopurinol and febuxostat reduce urate levels, but there are differences in how they are metabolized and eliminated. Cardiovascular risks connected with the disease and its treatment are presented. Acute gouty arthritis should be treated with nonsteroidal anti-inflammatory drugs (NSAIDs), colchicine or corticosteroids. Prolonged prophylaxis of acute gout is recommended when initiating urate-lowering therapy in order to prevent flares. The treat to target strategy may improve the quality of gout care.