To evaluate whether the clinical pattern of gout differed between elderly women and men a retrospective study was performed in all women (22) and men (18) in our rheumatological clinics who developed gout after the age of 60. The diagnosis was made after a mean of 2.6 years of joint complaints in women and after 1.2 years in men. In about half the patients complaints started in more than one joint, often including the big toe. In five women, but none of the men, complaints started in the fingers. No correlation was found between gout and the presence of tophi or Heberden's nodes in the finger joints. The mean uric acid level was higher in women (0.61 mmol/l) than in men (0.53 mmol/l), and almost all the women (95%) used diuretics and only 56% of the men did so.