Objective <p>The aim of this study was to evaluate the effect of arthroscopic removal of monosodium urate crystals on uric acid levels and acute flares in patients with gouty arthritis.</p> Methods <p>This was a case series study of seven male patients who underwent arthroscopic removal of monosodium urate crystals between March 2024 and July 2024. Physical examination, serology, musculoskeletal ultrasonography, and visual analog scale (VAS) scores were used to assess short- and long-term surgical outcomes. All patients received regular postoperative follow-up.</p> Results <p>Seven patients had a preoperative knee synovial thickness of (12.10 ± 2.03) mm and a VAS score of (7.43 ± 1.27). The postoperative wounds healed well and the patients were advised to control their diet and take uric acid-lowering medication regularly. The follow-up period was 3&#xa0;months, during which none of the patients had recurrence of the clinical manifestations of gouty arthritis. One-week postoperative review showed a synovial thickness of (8.51 ± 1.39) mm and a VAS score of (1.86 ± 0.69). Serologic results showed a significant decrease in uric acid levels at one week postoperatively and at the last follow-up compared to preoperative levels (<i>p</i> &lt; 0.0001 and <i>p</i> &lt; 0.0001, respectively).</p> Conclusion <p>Arthroscopic removal of urate deposits can effectively reduce patients’ uric acid levels and slow down their pain, and in combination with dietary and medication therapy can effectively control the recurrence of gouty arthritis, making it a It is a reliable surgical program for the treatment of gouty arthritis.</p>