OBJECTIVES: Determine the resources use and economic impact of patients with gout at the population level. METHODS: Observational design made from records belonging to 6 primary care centers and 2 hospitals. We included patients’ ≥18 years with an acute episode of gout. The patient follow-up was 2 years. It produced two study groups: patients with 1-2 attacks / acute recurrences and 3 or more. Main variables: demographic, co-morbidity, metabolic syndrome (MS), and resource use and health costs / non-health. Statistical analysis: logistic regression-model ANCOVA, P <0.05. RESULTS: 3,130 with gout were included. Prevalence: 3.3%, mean age: 55.8 years male: 81.1%. For groups: 68.4% had 1-2 acute attacks and 31.6% with 3 or more, p <0.001. The prevalence of MS was 28.8% (confidence interval [CI] 95% CI 27.2 to 30.4%). The average / unit cost was €2,228.6 (direct costs: 96.9%), 90.8% in primary care (visits: 23.5%; drugs: 57.7%). For groups, the average corrected model / unit total cost per patient was €2,130.6 vs. €2,605.4, respectively (P<0.001). In all cost components, the results were higher in the group with ≥3 attacks. The subgroup of diabetic patients (N=641, 20.5%) had a higher cost (compared to €3,124.8€ vs. €1,997.8, P<0.001). CONCLUSIONS: Gout is associated with substantial morbidity, presence of MS and resource consumption. The study provides useful data on the cost of the disease, being the costs of outpatient follow the highest.