© 2017 The Author(s). Background: To characterize the differences between women and men with gout. Methods: We analyzed a US national cohort of gout patients cared for by rheumatologists. Results: Compared with the 1012 men with gout, women with gout (n = 262) were older (71 vs. 61 years, p < 0.001) and had a greater burden of comorbid conditions (p < 0.001 for hypertension, diabetes, renal disease and obesity). Risk factors for gout differed with women more often taking diuretics (p < 0.001), while men more frequently had dietary triggers (p < 0.05). Conclusions: The profiles of women and men with gout are markedly different, suggesting a need to tailor treatment recommendations.