OBJECTIVES: Gout is often overlooked despite the pain caused by acute flares and the joint damage caused by the development of debilitating tophi (deposits of uric acid crystals). The study objective was to review and summarise the current evidence of the disease burden of chronic gout, in relation to health-related quality of life (HRQL), and to identify key factors correlated with an increased disease burden. Our primary aim was to support the economic evaluation of new treatments for gout. In addition, we identified key data gaps that may need further investigation. METHODS: A systematic literature review was conducted using the MEDLINE database and The Cochrane Library. Articles published in English between January 2000 and July 2014 that reported the humanistic burden (HRQL and/or utility) of gout were identified. Key data were extracted and summarised, with key themes and data gaps identified. RESULTS: Searches identified 323 studies, of which 21 were relevant to the humanistic burden of gout. The humanistic burden was largely due to physical disability and pain resulting from chronic clinical manifestations. Utility weights, as assessed by Short Form 6 dimensions, were estimated at 0.53 for a patient with severe gout (3+ flares/year and tophi) and 0.73 for an asymptomatic patient with serum uric acid levels <6mg/dL. CONCLUSIONS: The evidence confirms that gout represents a significant burden in terms of HRQL. A reported growing prevalence means this is likely to be of considerable concern for healthcare decision makers. In light of this, effective urate-lowering treatments are likely to be valued, if they can be clearly demonstrated to be both clinically effective and cost effective. There is a need to develop a comprehensive set of comparative HRQL utility assessments, especially in non-US countries.