Objective To investigate the incidence, diagnosis and treatment of carpal tunnel syndrome caused by gout. Methods A retrospective study of 252 patients with carpal tunnel syndrome who underwent surgery from January 2016 to December 2019, counting 16 of them caused by gout lesions. All 16 patients were treated with wrist incision and decompression, cleaning up tophi and releasing median nerve.Postoperative use of intramuscular injection of methylcobalamin nutritional neurotherapy, and oral treatment of uric acid. Results All the cases were cleared of tophi, the compression of the median nerve in the carpal tunnel was relieved, the numbness of the fingers was improved, the skin was not necrotic, and the wound was healed in stage I. After 6 months to 3 year follow-up（ Average 15 months）, no recurrence of the affected limb carpal tunnel syndrome, wrist and hand shape and function satisfactory. Conclusion For carpal tunnel syndrome caused by gout, surgical treatment is effective, can significantly improve the median nerve function and flexion and extension function.