Abstract:[Objective] To analyze the surgical classification of gouty tophi in hand and wrist, as well as the clinical outcomes of the corresponding surgical treatment. [Methods] A retrospective study was made on 39 patients who received surgical treatment for gouty stones in the hand and wrist from January 2016 to January 2023. The patients had the tophi classified according to their characteristics, including subcutaneous gouty tophi, tendinous gouty tophi, osteoarthritic gouty tophi, infectious gouty tophi. The gouty stones were removed and other corresponding surgical treatments were given based the classification, and the clinical consequences were evaluated. [Results] Of them, there were 11 cases of subcutaneous gouty tophi, 6 cased of tendinous gouty tophi, 17 cases of osteoarthritic gouty tophi and 5 cases of infectious gouty tophi. Among 39 patients, 2 patients had postoperative wound infection, which healed after debridement and antibiotic treatment. Delayed wound healing was noted in 5 patients , who got healed after dressing change. At 2 months postoperatively, all the patients had significant improvement in quality of life. Compared with those preoperatively, VAS scores [(5.6±1.3), (3.0±0.6), P＜0.001) and the Quick DASH score [(20.3±5.0), (7.6±2.7), P＜0.001] declined significantly at the latest follow-up. [Conclusion] According to the intraoperative findings, removal of gouty stone and the corresponding surgical treatment can effectively relieve pain and improve the function of the hand and wrist.