Gouty arthritis (GA), one of the most common forms of inflammatory arthritis, is characterized by elevated serum uric acid concentrations and the consequent deposition of monosodium urate crystals. Under low-grade inflammatory stress, cells tend to adapt to the microenvironment by reprogramming their metabolic pathways. Here we review the aberrant metabolic responses to the inflammatory environment in immune and tissue cells in distinct phases of GA. Regulation of these pathways is implicated in metabolic alterations including mitochondrial dysfunction, changes in the glycolytic pathway, and alteration of lipid, uric acid, and bone metabolism among others. Investigations of how these alterations lead to proinflammatory and anti-inflammatory effects in each period of GA have revealed links to its pathogenesis. Knowledge gained may open up new opportunities for diagnosis, treatment and prognosis of GA and offer rationale for further investigation into the mechanisms underlying the progression of the disease.