Background: Reports show patients with gout have serum-uric acid (SUA) levels within normal range during acute gout attacks. In studies, normouricemia was found in 12% to 63.3% of acute gout attacks. Proinflammatory cytokines can induce the release of cortisol, which has a uricosuric effect. Urate-lowering therapy (ULT) is not recommended to start during acute gout attacks. Methods: This research is cross-sectional observational study. The population is patients with acute gout attacks who received and didn’t receive ULT at Wahidin Sudirohusodo Hospital from November 2023 to June 2024. The statistical test was chi-square test. Results: Data analysis was carried out on 100 gout subjects consisting of 50 subjects with acute gout attacks and 50 as controls. In 50 subjects with acute gout attacks, hyperuricemia was found at 76% and normouricemia at 24% (pvalue=0.004). Hyperuricemia group had a risk of 3.431 times getting acute gout attack compared to normouricemia. Hyperuricemia-flare group didn’t receive more, namely 76%, compared to received ULT, namely 24% (pvalue=0.002). Conclusions: Comparison of SUA levels in acute gout attacks is mostly hyperuricemia compared to normouricemia. There were more acute gout attacks in hyperuricemia and normouricemia groups who didn’t receive than received ULT.