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Gout is a crystal-induced arthropathy which can start as an acute arthritis and over a few years become chronic and cause systemic complications. Acute gout can manifest as an emergency and cause misery. It is considered as one of the risk factors for hypertension, metabolic syndrome, and cardiovascular disease and when becomes chronic, may end in nephropathy. It may be primary or secondary. Recognition of gout is a simple exercise most of the times but may manifest with atypical features. This discussion is primarily on acute gout, hence its progression to chronic gouty arthritis and its attending complications has a passing mention.