This article performs a systematic literature review of the last decade studies assessing the economic impact of gout. The literature review confirms the fact that gout reduces productivity and increases annual total healthcare costs, since care of gout absorbs relevant amounts of healthcare resources. One important aspect to be considered is represented by prevention and monitoring of the disease after the diagnosis, as gout is sometimes underestimated by patients and this leads to a reduced adherence to follow up and to treatment with consequences on the disease course and outcome. In fact, the lack of prevention and the scarce adherence to monitoring increase the number and costs of hospitalisation. Prevention, monitoring the level of sUA and using a urate-lowering therapy appear to have a central role for controlling gout and reducing hospitalisation, with positive advantages in terms of healthcare costs and healthcare utilisation. One limitation on the analysis of gout related costs, however, resides in the fact that the majority of the retrieved studies are retrospective and the definition of the economic impact of the disease is made difficult by differences in inclusion criteria, costs assessment, use of gout-related healthcare resources.