Abstract: To overcome the inherent limitations of traditional observational studies, Mendelian randomization (MR) has been widely applied to investigate the causal risk factors for gout. This article reviews recent advances in the application of MR to gout research. Current evidence indicates that, with gout as the outcome, elevated body mass index, atherogenic dyslipidemia, and alcohol consumption are relatively well-established causal risk factors, whereas the causal roles of hypertension, physical activity, smoking, and coffee intake remain uncertain. With serum urate levels or hyperuricemia as the outcome, higher body mass index, abdominal obesity, genetic susceptibility to type 2 diabetes, sugar intake, and lower levels of physical activity have been shown to be causally associated with increased serum urate levels. Reverse MR analyses suggest that genetically predicted elevated serum urate levels are not clearly causally associated with type 2 diabetes, insulin resistance, or urolithiasis; in contrast, genetic liability to gout appears to be associated with an increased risk of hypertension and a decreased risk of colorectal cancer. Although MR studies still face challenges such as horizontal pleiotropy and limited population representativeness, future directions include integrating multi-omics data, advancing drug-target MR, and expanding research to non-European populations, which may provide important theoretical support for the precision prevention and treatment of gout.