Gout is an inflammatory arthritis characterized by red, tender, hot and tumid joints. The development cause and process of gout is very sophisticated; recent studies, notwithstanding, have offered novel perspectives on the mechanism from an immunological viewpoint. The pathological process of gout involves both innate and adaptive immune responses. Other studies have demonstrated that gout development is associated with the presence of monosodium urate (MSU) crystals which serve as a "danger signal" affecting certain immune cells, cytokine production, and effector molecule expression, triggering both types of immune responses. Different cell subsets, cytokines, pattern recognition receptors (PRRs) and the inflammasome have had noticeable effects on the pathogenesis of gout. In the present review, we discuss the contributions of MSU-mediated immune responses in gout, which helps to better understand the mechanism of gout development.