Objective: To analyze the association of total homocysteine (tHcy) levels with uric acid (UA) levels in gouty patients. Methods: We enrolled 193 male participants: 50 gouty patients without initiation of hypouricemic agent, group Ⅰ (Gr Ⅰ); 44 gouty patients after medical control of serum UA level, group Ⅱ (Gr Ⅱ); 49 community-based asymptomatic hyperuricemic patients, group Ⅲ (Gr Ⅲ); and 50 community-based normouricemic healthy subjects as control, group Ⅳ (Gr Ⅳ). Levels of tHcy and UA were measured for all subjects and repeated for Gr Ⅰ patients after treatment with allopurinol and group Ⅱ patients following withdrawal of allopurinol treatment for 2 months. Results: The results revealed that Gr Ⅰ (14.1±4.9 μmol/L) and Gr Ⅱ (12.7±3.4 μmol/L) had significantly higher serum tHcy levels than Gr Ⅳ (9.8±2.7 μmol/L) (p<0.001 and p=0.001 respectively) and Gr Ⅳ (9.2±2.4 μmol/L) (p<0.001 and p<0.001 respectively). There was no correlation between tHcy and UA levels for Gr Ⅰ (p=0.111, r=0.228). No significant difference was noted for tHcy levels in Gr I between preallopurinol treatment (14.1±4.9 μmol/L) and its post-treatment analogue (13.0±6.0 μmol/L) (p=0.31). The tHcy levels for Gr Ⅱ were significantly different between pre-allopurinol administration (12.7±3.4 μmol/L) and its post-withdrawal analogue (13.7±3.8 μmol/L) (p=0.022). The changes of UA levels after administration and withdrawal of allopurinol in Gr I and Gr Ⅱ respectively, do not correlate with the changes of tHcy. Conclusion: Elevated tHcy levels in gouty patients are not correlated with UA levels.