Introduction: Gout is the commonest inflammatory arthritis in adults that affects 4% of the US population. Gout is symptomatic, leading to joint pain and inflammation, frequent acute flares associated with disability, pain and suffering. When not treated optimally, chronic inflammation can lead to chronic pain, joint destruction and deformities and decrements in function and quality of life. Areas covered: Different therapeutic strategies that are being developed in preclinical and clinical settings are discussed. Expert opinion: Multiple new treatment approaches have emerged for gout. Several target acute inflammation of gout flares by inhibiting interleukin-1, either with an antibody or with a molecule that traps interleukin-1. Two drugs in this category are rilonacept and canakinumab. Similarly, new approaches targeting and increasing urate excretion by the kidney are emerging. One such promising drug is lesinurad that decreases serum urate through inhibition of the uric acid transporter (URAT1) in the proximal tubule of the kidney. We hope these and other new treatments and new strategies for gout will lead to additional options. The expansion of the armamentarium for gout treatment will allow clinicians and patients to increase the chances to have gout remission. © 2012 Informa UK, Ltd.