The authors discuss current options on the treatment of gout (acute gout attack, prophylaxis, management of hypouricemia) and asymptomatic hyperuricemia. They highlight the differences in individual guidelines in terms of the spectrum of drugs used, their preferences, dosing, dose titration, and goals of treatment as well as different positions over asymptomatic hyperuricemia. Further, the authors provide an overview of latest concepts related to uric acid and its association with some neurologic and cardiovascular diseases. Another issues discussed in the article are the completely different guidelines for general practitioners and their principles. In conclusion, the authors note that answers to some controversies in the treatment of gout can only be provided by data obtained from properly designed and conducted clinical trials. Key words: allopurinol - colchicine - glucocorticoids - gout - non-steroidal anti-inflammatory drugs - uric acid.