An association between high levels of serum uric acid and cardiovascular as well as renal disease has been proposed for many decades. However, only recently compelling basic science data, small clinical trials, and epidemiological studies have provided support to the idea of a true causal effect. In this noncomprehensive review, we present recently published data that evaluate the association between hyperuricemia and selected cardiovascular and renal diseases, with a final conclusion about the possibility of this association being causal.