Gout is a common rheumatic disease whose onset is directly linked to increased blood uric acid. Gout is a recurrent inflammatory disease caused by excessive uric acid production or poor uric acid excretion, resulting in uric acid crystals deposited in synovial membranes, bursae, cartilage and other tissues. The treatment of gout requires “both the symptoms and the root cause”, the main purpose of which is to control the pain during an attack; the root cause is more critical, usually during remission, and the main purpose is to lower the blood uric acid level. At present, the three most commonly used uric acid-lowering drugs in our clinic for uric acid-lowering treatment are: allopurinol, benzbromarone and febuxostat. So, why do I prefer febuxostat for uric acid-lowering treatment? What are the advantages and disadvantages of febuxostat? First of all, we have to start from the mechanism of uric acid-lowering treatment, and there are two categories of uric acid-lowering drugs: one is the drug that promotes the excretion of uric acid, whose function is to promote the kidney to “pull more and run faster” and increase the excretion of uric acid. But unfortunately, gout itself can cause renal insufficiency, and because this drug makes the kidneys “pull more and run faster”, it may worsen the already poor kidney function, so it is not recommended as the first choice by medical guidelines in various countries. It should not be used in patients with existing renal insufficiency or in patients with urinary stones. However, because the price of this drug is relatively low, it does not increase the financial burden of patients, so it is still widely used. The other type of drug is the drug that inhibits uric acid production, which can directly inhibit the production of uric acid in the body without adding extra burden to the kidneys, and is the drug recommended by the guidelines of various countries. There are two types of this drug: allopurinol and febuxostat. Allopurinol is inexpensive, has been used for many years, and has shown good results in some patients. Unfortunately, however, allopurinol has a high incidence of allergy because many Asian populations carry the HLA-B5801 gene, and allopurinol can have a serious adverse effect, STEVE JOHNSON syndrome, which can lead to death in some severely ill patients, and medical disputes due to this drug are common. Therefore, the drug is relatively dangerous and its use in China is limited. Febuxostat is a new class of drugs that inhibit uric acid production and has a strong effect on lowering uric acid, with the effect of 1 tablet of febuxostat being similar to that of 3 tablets of allopurinol. The occurrence of allergic reactions is significantly reduced, and the safety of drug use is good, basically no lethal allergic reactions. It also does not require adjustment of drug use in patients with impaired renal function because it is metabolized through the liver. Since it inhibits uric acid production from the beginning, it does not add extra burden to the kidneys and can be used safely by patients with urinary stones. Therefore, it is currently the first choice as a clinical uric acid-lowering drug. However, the fish and the bear’s paw cannot be combined, and the drug is expensive, costing about 800 yuan per month, which not all patients can afford. To sum up: if economic conditions allow, febuxostat should be preferred for lowering uric acid. If economic conditions do not allow, benzbromarone and allopurinol are also used after physician evaluation.