To evaluate the prevalence of primary gout in the Shantou area, China, and to understand its clinical features. Samples from three surveys of the Chenghai across ten years were studied. Clinical, laboratory and radiology data of 419 cases of primary gout were collected and analyzed. Prevalence of primary gout in the three surveys were 0.17%, 0.15% and 0.26%, respectively. Among the clinical patients, the ratio of male to female was 21:1; the average age of onset of women was significantly higher than that of men. The number of cases in the last ten years has been increasing. In the first wave of cases, the first metatarsophalangeal joint was involved in 82.1% of all cases; no fourth metatarsophalangeal joint involvement had been observed. Hyperlipemia was the most common accompanying abnormal laboratory test (57.1%). Radiographic bone erosion was found in 49.4% patients, most of them with disease duration more than 5 years. The prevalence of primary gout in Shantou area has been increasing in the last ten years. Changes in diet and lifestyle may be responsible for this rapid increase.