In this review, we synthesized existing information on BA-gout interactions, highlighting: the mechanistic interplay between BA dysregulation and gout pathogenesis across metabolic, immune, and microbial axes; the therapeutic potential of BA-targeted interventions (FXR antagonists, TGR5 agonists, and microbiota modulation) to concurrently address hyperuricemia and inflammation; and the clinical implications for gout management strategies. Here, NR1H4 is linked to gout.