“Disease of kings / royalty” in ancient times. It is caused by accumulation of sodium urate crystals in the joints. Normal uric acid level is less than 6mg/dL. Diagnosis of gout is by examining the synovial fluid from an affected joint. Risk factors for gout include obesity, some medications, chemotherapy, lead exposure, alcohol, genetics, joint injury, high triglycerides and blood pressure. Triggers for acute gout attack include joint injury, heavy alcohol intake, surgery, recent illness, crash diets, radiation, few medications, starting urate lowering agents. Gout can cause crippling deforming arthritis if untreated and can also affect kidney by forming stones or impairing its function. The big toe is the commonest site for acute gouty arthritis. The reason for this are: (a) the big toe becomes vulnerable and more prone to attack due to the pressure it receives from walking (b) urate crystals form more readily at cooler temperatures and big toes is cooler than the core body temperature. Lifestyle changes and self-care strategies in patient with gout include weight reduction, eating healthy and balanced diet, regular exercise, good hydration, less alcohol especially beer, regular medications and checking your uric acid levels regularly. Foods rich in purine should be used sparingly in patients who have gout. These include beer, meat (heart, kidney, brains, and mince meat), sea food (lobster, mackerel, oysters, sardines, shrimp). Patients should limit their intake of foods which have moderate purine content and these include asparagus, dried beans, spinach, lentils, other forms of meat, mushrooms and dried peas. Treatment of gout includes medicines which lower the uric acid levels by either reducing the production or increasing the excretion of uric acid and medicines to prevent acute flares or attacks.