BACKGROUND: The prevalence of hyperuricemia (HU) is likely to be underestimated in Japan as previous studies reporting on prevalence have been based only on health checkup data and did not take into account anti-hyperuricemic medication use and its effect on serum uric acid (SUA) levels.  OBJECTIVES:  To estimate more accurately the prevalence of HU in Japan by taking into account HU patients receiving drug therapy. METHODS:  The MinaCare database, which includes linked health checkup and claims data, was used to estimate prevalence of HU. The study population consisted of subjects who had at least one SUA measurement from health checkup data between fiscal years (FY) 2010-2014 (FY=April 1^st – March 31^st). HU was defined as an SUA level > 7.0 mg/dL in health checkup data and/or a prescription of anti-hyperuricemic medication in claims data. RESULTS:  The prevalence of HU in FY 2014 was 26.8% (95% confidence interval [CI]: 26.2~27.3%) in male subjects and 0.9% (95% CI: 0.7~1.0%) in female subjects. Overall, prevalence increased with the advancement in age (Prevalence in males was 19.8%, 25.1%, 27.1%, 29.4%, 29.5%, 30.6% and in females was 0.2%, 0.6%, 0.9%, 1.7%, 1.6%, 3.5% for age groups of <30, 30-<40, 40-<50, 50-<60, 60-<65, >65, respectively) and the prevalence of HU was higher in subjects with high BMI, hypertension or hyperlipidemia. Similar results were observed in other FY periods. CONCLUSIONS:  This is the first study of the prevalence of HU in Japan that takes into account both SUA levels and therapeutic status. The prevalence was higher than what has been reported in previous studies and it is considered to be a more accurate estimate of HU prevalence.