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OBJECTIVES: A single-center, prospective, random, open-label study of acute gout patients treated with etanercept. METHODS: The treatment protocol involved subcutaneous administration of etanercept at a dose of 25 mg twice in five days. The control group received 20 mg of methylprednisolone administered intravenously every day for a total of five days. Baseline assessments, conducted at the initiation of etanercept included visual analogue scale (VAS) scores and C-reactive protein (CRP) levels. The levels of CRP and VAS in the gout patient after being injected with etanercept or methylprednisolone for 5 days. Adverse events were diligently recorded throughout the study period. RESULTS: Etanercept demonstrated rapid and substantial alleviation of pain and inflammatory responses in all 12 acute gout patients. Its effect is comparable to that of methylprednisolone. CONCLUSION: Etanercept might be contemplated for "off-label" use in gout patients who do not respond to standard therapy or glucocorticoid therapy, encounter severe side-effects and contraindications.