Gout is the most common form of inflammatory arthropathy and is caused by an excess of uric acid in the blood (hyperuricemia). It is a chronic, debilitating condition that gradually increases in severity and affects an increasing number of people. It has a wide spectrum of clinical manifestations and is related to serious kidney and cardiovascular conditions and to an increased risk of mortality. The negative perception of the disease, historically seen as related to a life of dissipation, has led to underestimating its impact and focusing the attention on the short-term treatment of acute attacks rather than on the long-term management of the condition without, consequently, preventing the most serious complications. The most recent scientific evidence and the increasing understanding of the physio-pathologic mechanisms responsible for hyperuricemia and gout reveal a very different reality, in which gout is a condition which is only minimally affected by lifestyle and mainly by increasingly better identified genetic factors. Appropriate doctor training and patient education, catalyzed by the renewed attention to this disease and to new treatment options which overcome the limits of therapies currently available, will help to break down current barriers to allow for its optimal management.