Objective To analyze the clinical significance of elevated serum carbohydrate antigen 724 (CA724) in gout patients. Methods The clinical data of 271 gout patients, 63 ankylosing spondylitis patients, 40 psoriatic arthritis patients, 67 osteoarthritis patients and 280 healthy controls in our hospital from Jul. 2016 to Jun. 2019 were retrospectively analyzed. The positive rates and levels of serum CA724 were compared among gout patients and ankylosing spondylitis patients, psoriatic arthritis patients, osteoarthritis patients and healthy controls. According to the clinical symptoms and signs, gout patients were also divided into acute-stage group (n=53) and chronic-stage group (n=218); the serum CA724 levels were compared between the two groups and the correlation between serum CA724 level with white blood cell count and C-reactive protein (CRP) was analyzed in acute-stage gout patients. According to the serum CA724 level, gout patients were divided into elevated serum CA724 group (n=63) and normal serum CA724 group (n=208), and the serum uric acid, triglyceride, and high-density lipoprotein were compared between the two groups. Results The positive rate of serum CA724 in gout patients was significantly higher than those in ankylosing spondylitis patients, psoriatic arthritis patients, osteoarthritis patients and healthy controls (P<0.05, P<0.01). Serum CA724 in gout patients was significantly higher than those in osteoarthritis patients and healthy controls (P<0.05, P<0.01). Serum CA724 in acute-stage gout patients was significantly higher than that in chronic-stage gout patients (P<0.01), and it was positively correlated with white blood cell count and CRP (both P<0.01). The levels of serum uric acid and triglyceride in gout patients with elevated serum CA724 were significantly higher than those in patients with normal serum CA724 (P<0.01, P<0.05), while the level of high-density lipoprotein was significantly lower than that in normal serum CA724 group (P<0.01). Conclusion Serum CA724 level is increased in some gout patients, and serum CA724 is correlated with acute gout attack and inflammation.