Our objective was to analyze serum total homocysteine (tHcy) levels for gouty patients and to study whether there are any level changes following treatment with allopurinol. We enrolled 90 male participants including patients with primary gout (n=51) and community-based healthy controls (n=39). Fasting tHcy levels were determined for all subjects and repeat measurements performed for 29 patients following treatment with allopurinol. The results revealed that gouty patients exhibited significantly greater serum tHcy levels (12.10+/-3.19 micromol/l) than healthy controls did (9.96+/-2.16 micromol/l) (p=0.0003), although there was no obvious difference between the pre-allopurinol treatment group (12.54+/-3.31 micromol/l) and its post-treatment analogue (11.90+/-4.68 micromol/l) (n=29, p=0.33). Elevated serum levels of tHcy were noted for this cohort of male gouty patients as compared to healthy controls, and these tHcy levels did not appear to change substantially following treatment with allopurinol. Although the pathogenesis of hyperhomocysteinemia for gouty patients still remains somewhat obscure, this study suggests that tHcy levels cannot be effectively modulated by treatment with allopurinol.