This review provides an update on the most recent data on mortality in people with gout. A large prospective study among men found that those with gout have a higher risk of death from all causes. Among men who did not have pre-existing coronary heart disease, the increased mortality risk is due primarily to an elevated risk of cardiovascular death, particularly from coronary heart disease. Also, an extension study of a large clinical trial among men with above-average risk for coronary heart disease found that a diagnosis of gout accompanied by an elevated uric acid level is associated with increased long-term (approximately 17 years) risk of all-cause mortality that arises largely from an increased risk of cardiovascular disease (CVD) mortality. Although limited, these emerging data suggest that men with gout have a higher risk of death from all causes and the increased mortality risk is primarily due to an elevated risk of CVD death. These findings would provide support for the aggressive management of cardiovascular risk factors in men with gout. More data that adjust comprehensively for various associated CVD markers are needed to reinforce this concept. Furthermore, given apparent potential sex differences in gout epidemiology and its risk factors, prospective studies specifically among women would be valuable.