Li Q, Li X, Wang J, et al. - Twenty-four guidance documents (16 clinical practice guidelines and eight consensus statements) published between 2003 and 2017 were systematically reviewed and quality evaluation was done using the appraisal of guidelines for research and evaluation II methodology by the researchers to judge the quality and consistency of guidance documents for gout and hyperuricemia. In the domains of scope and purpose and clarity of presentation, involved documents did well, though, unsatisfactory in the applicability and editorial independence. The highest scores was given to the 2017 British Society of Rheumatology guideline. For long-term control, on the target serum uric acid level, suggestions were concordant on some indications for urate-lowering therapy (ULT), and on the first-line drugs for ULT and for an acute attack. For many items, substantially inconsistent recommendations were provided, particularly for the timing of initiation of ULT and for treatment for asymptomatic hyperuricemia. Therefore, in guidance documents on gout and hyperuricemia, methodological quality requires improvement. However, there is a lack of evidence for specific clinical questions, irrespective of numerous trials in this field. Further, to decrease recommendation inconsistencies, promoting standard guidance development methods and synthesizing high-quality clinical evidence are potential strategies.